Healthcare Provider Details

I. General information

NPI: 1932495637
Provider Name (Legal Business Name): SAINT FRANCIS CARDIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6005 PARK AVE STE. 500B
MEMPHIS TN
38119-5215
US

IV. Provider business mailing address

6005 PARK AVE STE. 500B
MEMPHIS TN
38119-5215
US

V. Phone/Fax

Practice location:
  • Phone: 901-683-6925
  • Fax: 901-684-1435
Mailing address:
  • Phone: 901-683-6925
  • Fax: 901-684-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY ADAMS
Title or Position: SVP REGIONAL OPERATIONS, TENET
Credential:
Phone: 469-893-2563