Provider Demographics
NPI:1467494070
Name:APEX CARDIOLOGY PC
Entity Type:Organization
Organization Name:APEX CARDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHSIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ALHADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-423-8200
Mailing Address - Street 1:PO BOX 1000 DEPT 895
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0895
Mailing Address - Country:US
Mailing Address - Phone:731-423-8200
Mailing Address - Fax:731-423-6200
Practice Address - Street 1:327 SUMMAR DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3930
Practice Address - Country:US
Practice Address - Phone:731-423-8200
Practice Address - Fax:731-423-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28542207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370438Medicaid
TN3370438Medicare PIN