Organization
SJL PHYSICIAN MANAGEMENT SERVICES INC.
Active
Other names
dba Premier Heart and Vascular Centers
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEL JONES CPA (VP REVENUE CYCLE & BUSINESS SERVICE)
(606) 877-3918
Entity
Organization
Contact information
Practice address
1210 W 5TH ST, LONDON, KY 40741-2112
(606) 864-4040
(606) 864-3500
Mailing address
PO BOX 2638, LONDON, KY 40743-2638
(606) 864-4040
(606) 877-1722
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
KY
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
KY
207RI0011X
Interventional Cardiology Physician
—
KY
363A00000X
Physician Assistant
—
KY
363L00000X
Nurse Practitioner
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000638615
ANTHEM BCBS PIN
KY
01
—
C21207
CHI
KY
Enumeration date
06/24/2009
Last updated
02/25/2010
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