# GRANITE CITY PHYSICIANS CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HEARTLAND HEALTHCARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073567483
- **Authorized official:** LAURA J FEY (SR. DIRECTOR PHYSICIAN REV CYCLE)
- **Authorized official phone:** (615) 221-3641

## Contact information

- **Practice address:** 2044 MADISON AVE, SUITE 15, GRANITE CITY, IL 62040-4641
- **Practice address phone:** (618) 798-8652
- **Practice address fax:** (618) 798-8116
- **Mailing address:** 1573 MALLORY LN STE 100, BRENTWOOD, TN 37027-2895
- **Mailing address phone:** (152) 221-1400
- **Mailing address fax:** (618) 628-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 07/07/2023