Provider Demographics
NPI:1639261944
Name:UVPC SPECIALISTS INC.
Entity Type:Organization
Organization Name:UVPC SPECIALISTS INC.
Other - Org Name:STANFIELD CTV SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-440-7497
Mailing Address - Street 1:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-0479
Mailing Address - Country:US
Mailing Address - Phone:937-335-6463
Mailing Address - Fax:937-440-7230
Practice Address - Street 1:31 S STANFIELD RD
Practice Address - Street 2:SUITE 206
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2374
Practice Address - Country:US
Practice Address - Phone:937-335-6463
Practice Address - Fax:937-440-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-06-18
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
OH9359421Medicare ID - Type Unspecified