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General NPI Number Information
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NPI Number | 1437148152
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC CARDIOLOGY GROUP
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 2341 MCCALLIE AVE PLAZA 3, STE. 200
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3239
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Country | US
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Telephone | 423-629-4106
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Fax | 423-629-4116
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Provider Business Mailing Address
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Address Line | 2341 MCCALLIE AVE PLAZA 3, STE. 200
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3239
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Country | US
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Telephone | 423-629-4106
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Fax | 423-629-4116
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Authorized Official
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Title or Position | CEO
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Name | THEODORE RICHARDS
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Credential | MD
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Telephone | 423-629-4106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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