Organization
PROVIDENCE CARDIOLOGY TESTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK HUG KLIE MD (PRESIDENT)
(401) 521-0700
Entity
Organization
Contact information
Practice address
1 RANDALL SQ, SUITE 305, PROVIDENCE, RI 02904-2709
(401) 521-0700
(401) 521-0906
Mailing address
1 RANDALL SQ, SUITE 305, PROVIDENCE, RI 02904-2709
(401) 521-0700
(401) 521-0906
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4568
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001218
BLUE CHIP
RI
01
—
849
BLUE CROSS
RI
05
—
90002630
—
RI
Enumeration date
11/09/2006
Last updated
03/12/2009
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