Provider Demographics
NPI:1962484220
Name:SOUTHERN HEART GROUP
Entity Type:Organization
Organization Name:SOUTHERN HEART GROUP
Other - Org Name:DIAGNOSTIC CARDIOLOGY ASSOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:PILCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-388-1820
Mailing Address - Street 1:562 PARK ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-2918
Mailing Address - Country:US
Mailing Address - Phone:904-633-2021
Mailing Address - Fax:904-633-9793
Practice Address - Street 1:1824 KING ST
Practice Address - Street 2:SUITE 300
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4735
Practice Address - Country:US
Practice Address - Phone:904-388-1820
Practice Address - Fax:904-388-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3918OtherGEORGIA MEDICARE
FLCH8079OtherRAILROAD MEDICARE
FLCI0090OtherRAILROAD MEDICARE
GAGRP3918OtherGEORGIA MEDICARE