Mexico Cardiovascular Associates LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

36412 Issued in MO

Legal business name

MEXICO CARDIOVASCULAR ASSOCIATES LLC

Practice address

720 Medical Park Dr
Mexico, MO 65265-3726

Phone

(573) 581-3240

Fax

(573) 581-7493

NPI assigned

Jul 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles Herbert Tillman Jr., M.D.

Title

Owner/Partner

Phone

(573) 581-3240

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1952322893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 MEDICAL PARK DR",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653726",
            "telephone_number": "573-581-3240",
            "fax_number": "573-581-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MEDICAL PARK DR",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653726",
            "telephone_number": "573-581-3240",
            "fax_number": "573-581-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEXICO CARDIOVASCULAR ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HERBERT",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "573-581-3240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "36412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Zidick McClarey, MS, ATC
• Simon John McKeown, M.D.
• Dwight E. McLeod, D.D.S. M.S.
• Linda Marie McManus, RPH
• Medical Imaging Associates of Mexico Mo
• Mexico Eye Center, L.L.C.
• Mexico Internal Medicine, LLP
• Mexico Manor, Inc.
• Mexico Medical Specialists, L.C.
• Mexico Public Schools

• Cardiovascular Disease Physician in Mexico, MO
• Providers in Mexico, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.