Organization
CENTRAL CARDIOLOGY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA PRUITT (ADMINISTRATOR)
(270) 765-5921
Entity
Organization
Contact information
Practice address
1324 WOODLAND DRIVE, SUITE A, ELIZABETHTOWN, KY 42701
(270) 765-5921
(270) 769-0000
Mailing address
1324 WOODLAND DRIVE, SUITE A, ELIZABETHTOWN, KY 42701
(270) 765-5921
(270) 769-0000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65912859
—
KY
Enumeration date
04/14/2006
Last updated
09/17/2013
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