Provider Demographics
NPI:1508036575
Name:HEART ASSOCIATES OF CENTRAL MS
Entity Type:Organization
Organization Name:HEART ASSOCIATES OF CENTRAL MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-936-3102
Mailing Address - Street 1:5903 RIDGEWOOD RD
Mailing Address - Street 2:SUITE230
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3700
Mailing Address - Country:US
Mailing Address - Phone:601-899-3250
Mailing Address - Fax:601-929-0241
Practice Address - Street 1:5903 RIDGEWOOD RD
Practice Address - Street 2:SUITE230
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-3700
Practice Address - Country:US
Practice Address - Phone:601-899-3250
Practice Address - Fax:601-929-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty