Organization
WESTERN KENTUCKY CARDIOLOGY CONSULTANTS, PSC
Active
Other names
The Heart Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES S. GWINN JR. M.D. (PRESIDENT)
(270) 415-0361
Entity
Organization
Contact information
Practice address
2601 KENTUCKY AVE, DOB 1 SUITE 301, PADUCAH, KY 42003-3817
(270) 575-3113
(270) 575-3135
Mailing address
PO BOX 7648, PADUCAH, KY 42002-7648
(800) 467-2392
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
KY
363AM0700X
Medical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0855626
UMW PROV. GROUP NUMBER
KY
01
—
2152
BLUE SHIELD
KY
05
—
4406729
—
TN
Enumeration date
08/31/2006
Last updated
08/03/2011
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