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General NPI Number Information
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NPI Number | 1255417598
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Entity Type | Organization
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Legal Business Name | TENNESSEE VALLEY CARDIOVASCULAR CENTER, PC
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Dates
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Enumeration Date | 10/30/2006
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 1120 S JACKSON HWY SUITE 302
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City | SHEFFIELD
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State | AL
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Zip | 35660-5777
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Country | US
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Telephone | 256-383-8066
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Fax | 256-383-8727
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Provider Business Mailing Address
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Address Line | 1120 S JACKSON HWY SUITE 302
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City | SHEFFIELD
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State | AL
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Zip | 35660-5777
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Country | US
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Telephone | 256-383-8066
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Fax | 256-383-8727
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Authorized Official
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Title or Position | CREDENTIALS SPECIALIST
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Name | TAMMY VARIE HADDOCK
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Credential |
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Telephone | 256-766-2118
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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 | 23786
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License Number State | AL
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