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General NPI Number Information
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NPI Number | 1861727471
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Entity Type | Organization
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Legal Business Name | BLUFF CITY CARDIOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 6005 PARK AVE LOEWENBERG BLDG STE 902
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City | MEMPHIS
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State | TN
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Zip | 38119-5202
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Country | US
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Telephone | 901-761-9998
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Fax |
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Provider Business Mailing Address
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Address Line | 6005 PARK AVE LOEWENBERG BLDG STE 902
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City | MEMPHIS
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State | TN
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Zip | 38119-5202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BLANCHE SAXTON
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Credential |
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Telephone | 901-761-9998
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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 | MD0000011627
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License Number State | TN
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