Provider Demographics
NPI:1669453304
Name:CARDIOVASCULAR SURGERY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CARDIOVASCULAR SURGERY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF THE CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEA
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:615-385-4781
Mailing Address - Street 1:95 WHITE BRIDGE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1497
Mailing Address - Country:US
Mailing Address - Phone:615-354-5930
Mailing Address - Fax:615-356-5220
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-4781
Practice Address - Fax:615-385-9265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2009-10-14
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
TN3374168Medicaid
TN3374168Medicaid