Organization
CARDIOLOGISTS OF CLARK & CHAMPAIGN COUNTIES
Active
Parent organization
CARDIOLOGISTS OF CLARK & CHAMPAIGN COUNTIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARDIOLOGISTS OF CLARK & CHAMPAIGN COUNTIES
Authorized official
MS. SUSAN KAE GABBARD CPC (BILLING SUPERVISOR)
(937) 323-5064
Entity
Organization
Contact information
Practice address
900 E COURT ST, URBANA, OH 43078-1887
(937) 653-8897
(937) 653-7261
Mailing address
1911 E HIGH ST, SPRINGFIELD, OH 45505-1227
(937) 323-5064
(937) 323-1404
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0942412
—
OH
01
—
CM7602
RAILROAD MEDICARE
OH
Enumeration date
10/15/2007
Last updated
10/17/2011
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