Organization
THE HEART CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M FULLER MD (OWNER/PHYSICIAN)
(601) 936-5311
Entity
Organization
Contact information
Practice address
1040 RIVER OAKS DR, SUITE 100 PROFESSIONAL CENTER, FLOWOOD, MS 39232-9530
(601) 936-5311
Mailing address
1040 RIVER OAKS DR, SUITE 100 PROFESSIONAL CENTER, FLOWOOD, MS 39232-9530
(601) 936-5311
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14934
MS
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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