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Organization
CARDIOVASCULAR SURGICAL CLINIC PA
Active
Organization
CARDIOVASCULAR SURGICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL HARTMAN (ADMINISTRATOR)
(601) 948-1416
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 100, JACKSON, MS 39202-1651
(601) 948-1416
(601) 353-9417
Mailing address
501 MARSHALL ST, SUITE 100, JACKSON, MS 39202-1651
(601) 948-1416
(601) 353-9417
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09011173
—
MS
Enumeration date
01/12/2007
Last updated
08/22/2020
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