Provider Demographics
NPI:1518989003
Name:HINDS CARDIOLOGY CLINIC PA
Entity Type:Organization
Organization Name:HINDS CARDIOLOGY CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AYN
Authorized Official - Middle Name:TUCKER
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-372-2777
Mailing Address - Street 1:1832 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-3410
Mailing Address - Country:US
Mailing Address - Phone:601-372-2777
Mailing Address - Fax:601-914-0904
Practice Address - Street 1:1832 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-3410
Practice Address - Country:US
Practice Address - Phone:601-372-2777
Practice Address - Fax:601-914-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C00453Medicare PIN