Batesville Cardiology PA
Organization Active NPI Specialist · Batesville, AR
NPI 1770548356 · NPPES record last updated Oct 22, 2010
Key facts
- NPI
- 1770548356
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 5608 (AR)
- Legal business name
- BATESVILLE CARDIOLOGY PA
- Practice address
- 1695 Harrison St
Batesville, AR 72501 - Phone
- (870) 793-7519
- Fax
- (870) 793-8146
- NPI assigned
- Apr 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Martha Lynn Simmons
- Title
- Office Manager
- Phone
- (870) 793-7519
Practitioners 4
-
Ellen Lavera Qualls, APN
-
Richard Vangrouw, M.D.
-
Qaisar M Khan, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 5608 | AR | Yes |
Addresses
Primary practice location
1695 Harrison St
Batesville, AR 72501
Mailing address
16 Hospital Cir Ste a
Batesville, AR 72501-7343
Phone (870) 793-7519
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102776002 | Medicaid | AR |
Other providers in Batesville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.