Organization
MEDICAL CENTER CARDIOLOGISTS, PSC
Active
Parent organization
MEDICAL CENTER CARDIOLOGISTS, PSC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL CENTER CARDIOLOGISTS, PSC
Authorized official
DR. JESSE E ADAMS III M.D. (PRESIDENT)
(502) 585-4321
Entity
Organization
Contact information
Practice address
1023 NEW MOODY LN, SUITE 101, LAGRANGE, KY 40031-9177
(502) 222-4551
(502) 222-5821
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
—
65908808
—
KY
05
—
78902632
—
KY
05
—
95900502
—
KY
Enumeration date
05/21/2007
Last updated
09/27/2007
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