Organization
CARDIOLOGISTS OF CLARK & CHAMPAIGN COUNTIES
Active
Parent organization
CARDIOLOGIST OF CLARK & CHAMPAIGN COUNTIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARDIOLOGIST OF CLARK & CHAMPAIGN COUNTIES
Authorized official
MS. SUSAN KAE GABBARD CPC (PRACTICE ADMINISTRATOR)
(937) 523-9555
Entity
Organization
Contact information
Practice address
100 W. MCCREIGHT AVE, STE 150, SPRINGFIELD, OH 45504
(937) 323-1404
(937) 323-1407
Mailing address
100 W. MCCREIGHT AVE, STE 150, SPRINGFIELD, OH 45504
(937) 323-1404
(937) 323-1407
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RC0000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0942412
—
OH
01
—
CM7602
RAILROAD MEDICARE
OH
Enumeration date
07/04/2006
Last updated
01/30/2017
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