MEDICARE: HUNTSVILLE CARDIOTHORACIC SURGEONS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

General Provider Information

NPI Number	:	1336132281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTSVILLE CARDIOTHORACIC SURGEONS, PC

Provider Business Mailing Address
First Line	:	201 SIVLEY RD SW
Second Line	:	SUITE 300
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5134
Country	:	US
Telephone Number	:	256-533-1077
Fax Number	:	256-533-3379

Provider Business Practice Location Address
First Line	:	201 SIVLEY RD SW
Second Line	:	SUITE 300
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5134
Country	:	US
Telephone Number	:	256-533-1077
Fax Number	:	256-533-3379

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD LLOYD CLAY
Credential	:	M.D.
Telephone Number	:	256-533-1077

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	07/24/2007

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