Organization
SOUTH CENTRAL HEART GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY TODD HILL (EXECUTIVE DIRECTOR)
(931) 540-4255
Entity
Organization
Contact information
Practice address
1220 TROTWOOD AVE, SUITE 401, COLUMBIA, TN 38401-6433
(931) 388-8622
(931) 388-8227
Mailing address
854 W JAMES CAMPBELL BLVD, SUITE 303A, COLUMBIA, TN 38401-4659
(931) 540-4255
(931) 490-4654
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3379860
—
TN
01
—
4074604
BLUECROSS BLUESHIELD
TN
Enumeration date
05/12/2006
Last updated
04/04/2008
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