MEDICARE: APPALACHIAN CARDIOVASCULAR ASSOCIATES

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	207RI0011X	Interventional Cardiology Physician	24558	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060069630	OTHER	AL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51511919	OTHER	AL	BCBS OF ALABAMA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508993668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPALACHIAN CARDIOVASCULAR ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 681239
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35968-1613
Country	:	US
Telephone Number	:	256-997-9200
Fax Number	:	256-997-0002

Provider Business Practice Location Address
First Line	:	1990 GAULT AVE N
Second Line	:	SUITE 200
City	:	FORT PAYNE
State	:	AL
Zip	:	35967-3418
Country	:	US
Telephone Number	:	256-997-9200
Fax Number	:	256-997-0002

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SANJEEV SAXENA
Credential	:	M.D.
Telephone Number	:	256-997-9200

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	10/24/2011

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Directions to “APPALACHIAN CARDIOVASCULAR ASSOCIATES ” Practice Location

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