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General NPI Number Information
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NPI Number | 1447231097
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Entity Type | Organization
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Legal Business Name | NORTHWEST TENNESSEE CARDIOLOGY CLINIC, P. C.
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 1304 MEDICAL PARK CIR
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City | UNION CITY
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State | TN
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Zip | 38261-5876
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Country | US
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Telephone | 731-886-1212
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Fax | 731-886-1220
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Provider Business Mailing Address
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Address Line | 1304 MEDICAL PARK CIR
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City | UNION CITY
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State | TN
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Zip | 38261-5876
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Country | US
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Telephone | 731-886-1212
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Fax | 731-886-1220
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES C HALL
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Credential | M.D.
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Telephone | 731-886-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17501
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License Number State | TN
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