Provider Demographics
NPI:1023080348
Name:CARLISLE CARDIOLOGY ASSOCIATES, PC
Entity type:Organization
Organization Name:CARLISLE CARDIOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:KANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-258-8862
Mailing Address - Street 1:850 WALNUT BOTTOM RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3632
Mailing Address - Country:US
Mailing Address - Phone:717-258-8862
Mailing Address - Fax:717-258-9887
Practice Address - Street 1:850 WALNUT BOTTOM RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3632
Practice Address - Country:US
Practice Address - Phone:717-258-8862
Practice Address - Fax:717-258-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1374187OtherHIGHMARK ID
PA2804517OtherAETNA
PACJ9486OtherRAILROAD MEDICARE
PA0077587710002Medicaid
PA03248500OtherCAPITAL BLUE CROSS ID
PACJ9486OtherRAILROAD MEDICARE