Provider Demographics
NPI:1336132281
Name:HUNTSVILLE CARDIOTHORACIC SURGEONS, PC
Entity Type:Organization
Organization Name:HUNTSVILLE CARDIOTHORACIC SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-533-1077
Mailing Address - Street 1:201 SIVLEY RD SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5134
Mailing Address - Country:US
Mailing Address - Phone:256-533-1077
Mailing Address - Fax:256-533-3379
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-533-1077
Practice Address - Fax:256-533-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD999Medicare PIN