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General NPI Number Information
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NPI Number | 1336295062
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Entity Type | Organization
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Legal Business Name | HEARTLAND CARDIOTHORACIC SURGERY PLLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 1107 CROWN POINTE DR SUITE C
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7123
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Country | US
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Telephone | 270-234-1982
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Fax | 270-234-1952
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Provider Business Mailing Address
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Address Line | 1107 CROWN POINTE DR SUITE C
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7123
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Country | US
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Telephone | 270-234-1982
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Fax | 270-234-1952
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Authorized Official
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Title or Position | PHYSICIAN
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Name | WILLIAM HYMES
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Credential | MD
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Telephone | 270-234-1982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 29525
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License Number State | KY
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