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General NPI Number Information
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NPI Number | 1003860701
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Entity Type | Organization
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Legal Business Name | THE HEART CLINIC, P.C.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 1700 HOSPITAL SOUTH DR SUITE 302
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City | AUSTELL
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State | GA
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Zip | 30106-6810
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Country | US
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Telephone | 770-739-0999
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Fax | 678-945-8033
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Provider Business Mailing Address
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Address Line | 1700 HOSPITAL SOUTH DR SUITE 302
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City | AUSTELL
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State | GA
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Zip | 30106-6810
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Country | US
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Telephone | 770-739-0999
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Fax | 678-945-8033
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Authorized Official
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Title or Position | MANAGER PHYSICIAN SERVICES
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Name | MS. RHONDA CROWE
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Credential | L.P.N.
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Telephone | 770-739-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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