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General NPI Number Information
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NPI Number | 1063510618
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL CARDIOLOGY, PLLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 605 GLENWOOD DRIVE SUITE 412
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1175
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Country | US
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Telephone | 423-495-0521
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Fax | 423-648-0708
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Provider Business Mailing Address
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Address Line | 605 GLENWOOD DRIVE SUITE 412
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1175
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Country | US
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Telephone | 423-495-0521
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Fax | 423-648-0708
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN B STUBBLEFIELD
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Credential | MD
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Telephone | 423-495-0521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 012834
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License Number State | TN
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