Organization
MOUNTAIN HEART CENTER, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PADUBIDRI S CHANDRASHEKAR M.D. (PRESIDENT)
(606) 633-5520
Entity
Organization
Contact information
Practice address
714 JENKINS RD, WHITESBURG, KY 41858-7189
(606) 633-5520
(606) 633-5515
Mailing address
PO BOX 767, WHITESBURG, KY 41858-0767
(606) 633-5520
(606) 633-5515
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
29202
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65929432
—
KY
Enumeration date
07/30/2006
Last updated
04/05/2017
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