Organization
MEDICAL CENTER CARDIOLOGISTS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE E ADAMS III M.D. (PRESIDENT)
(502) 585-4321
Entity
Organization
Contact information
Practice address
400 EXECUTIVE PARK, LOUISVILLE, KY 40207-4204
(502) 585-4321
(502) 895-6083
Mailing address
PO BOX 2409, LOUISVILLE, KY 40201-2409
(502) 585-4321
(502) 895-6083
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1048829
—
KY
05
—
2432239000
—
KY
05
—
65908808
—
KY
05
—
78902632
—
KY
05
—
95900502
—
KY
01
—
CA8894
RAILROAD MEDICARE
KY
01
—
CB5788
RAILROAD MEDICARE
IN
Enumeration date
05/24/2007
Last updated
11/12/2007
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