Healthcare Provider Details
I. General information
NPI: 1073906616
Provider Name (Legal Business Name): APEX CARDIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2015
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
557 W PARK PL
HENDERSON TN
38340-2027
US
IV. Provider business mailing address
557 W PARK PL
HENDERSON TN
38340-2027
US
V. Phone/Fax
- Phone: 731-989-1007
- Fax: 731-988-0704
- Phone: 731-989-1007
- Fax: 731-988-0704
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAMERON
S
BURKS
Title or Position: OFFICE MANAGER
Credential:
Phone: 731-989-1007