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General NPI Number Information
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NPI Number | 1093195869
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Entity Type | Organization
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Legal Business Name | HEART TO HEART PEDIATRIC CARDIOLOGY
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 3801 SPRINGHURST BLVD STE 104
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City | LOUISVILLE
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State | KY
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Zip | 40241-6137
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Country | US
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Telephone | 502-425-5614
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Fax | 502-425-5633
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Provider Business Mailing Address
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Address Line | 1111 BALMORAL DR
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City | LOUISVILLE
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State | KY
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Zip | 40205-3331
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Country | US
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Telephone | 502-425-5614
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Fax | 502-425-5633
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Authorized Official
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Title or Position | OWNER
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Name | LISA R. KLEIN
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Credential | MD
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Telephone | 502-425-5614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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