MEDICARE: KNOX CARDIOLOGY ASSOCIATES, INC.

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	207RC0000X	Cardiovascular Disease Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CF1310	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992817365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNOX CARDIOLOGY ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	7 WOODLAKE TRL
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-8103
Country	:	US
Telephone Number	:	740-397-0108
Fax Number	:	740-397-0800

Provider Business Practice Location Address
First Line	:	7 WOODLAKE TRL
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-8103
Country	:	US
Telephone Number	:	740-397-0108
Fax Number	:	740-397-0800

Authorized Official
Title or Position	:	OFFICE ADMINISTRATOR
Name	:	MRS. JUDY A. HINES
Credential	:
Telephone Number	:	740-397-0108

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/26/2009

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Directions to “KNOX CARDIOLOGY ASSOCIATES, INC. ” Practice Location

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