Organization
CARDIOVASCULAR CLINIC OF WEST TN PC
Active
Other names
Cardiovascular Clinic of West Tennessee P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEYINKA ADEBORYO AGBETOYIN MD (CARDIOLOGIST)
(731) 256-1819
Entity
Organization
Contact information
Practice address
2968 NORTH HIGHLAND AVENUE, JACKSON, TN 38305-3609
(731) 256-1819
(731) 664-4330
Mailing address
2968 NORTH HIGHLAND AVENUE, JACKSON, TN 38305-3609
(731) 256-1819
(731) 664-4330
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36918
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1501077
—
TN
01
—
4160707
BCBS
TN
Enumeration date
07/25/2007
Last updated
12/10/2010
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