Cardiology Associates of Vidalia, P.C.

Organization Active NPI Interventional Cardiology Physician · Vidalia, GA

NPI 1356530901 · NPPES record last updated Apr 20, 2015

Key facts

NPI
1356530901
Entity type
Organization (NPI type 2)
Primary specialty
Interventional Cardiology Physician 207RI0011X
License
025159 (GA)
Legal business name
CARDIOLOGY ASSOCIATES OF VIDALIA, P.C.
Practice address
1006 Mount Vernon Rd
Vidalia, GA 30474-3029
Phone
(912) 537-1221
Fax
(912) 537-1012
NPI assigned
Oct 19, 2007
Organization subpart
No

Authorized official

Name
Ms. Elaine Giles
Title
Office Manager
Phone
(912) 537-1221

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RI0011X 025159 GA Yes

Addresses

Primary practice location

1006 Mount Vernon Rd
Vidalia, GA 30474-3029

Mailing address

1006 Mount Vernon Rd
Vidalia, GA 30474-3029
Phone (912) 537-1221

Other identifiers

IdentifierTypeStateIssuer
000348169RMedicaidGA
252783403OtherGATRICARE
060062628OtherGARAILROAD MEDICARE
1104827369OtherGANPI - INDIVIDUAL

Other providers in Vidalia, GA

All providers in Vidalia, GA · Interventional Cardiology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.