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General NPI Number Information
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NPI Number | 1528275880
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Entity Type | Organization
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Legal Business Name | WITTUM CARDIOLOGY SERVICES, LLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 919 E SPRING ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-2944
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Country | US
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Telephone | 812-944-1842
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Fax |
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Provider Business Mailing Address
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Address Line | 1906 GRAPE ARBOR WAY
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City | FLOYDS KNOBS
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State | IN
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Zip | 47119-9026
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Country | US
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Telephone | 812-981-0662
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. LAURA L SPRINKLE
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Credential |
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Telephone | 812-923-4106
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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 | 01059720A
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License Number State | IN
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