Provider Demographics
NPI:1578610705
Name:CARDIOVASCULAR SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:CARDIOVASCULAR SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-456-0228
Mailing Address - Street 1:815 RIVERBEND DR
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-2556
Mailing Address - Country:US
Mailing Address - Phone:256-456-0228
Mailing Address - Fax:256-456-0231
Practice Address - Street 1:815 RIVERBEND DR
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-2556
Practice Address - Country:US
Practice Address - Phone:256-456-0228
Practice Address - Fax:256-456-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK595Medicare ID - Type UnspecifiedPROVIDER NUMBER