Provider Demographics
NPI:1740276450
Name:MID-STATE CARDIOLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:MID-STATE CARDIOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CROSSLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:615-329-5144
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1852
Mailing Address - Country:US
Mailing Address - Phone:615-329-5144
Mailing Address - Fax:615-284-2751
Practice Address - Street 1:222 22ND AVE N
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1852
Practice Address - Country:US
Practice Address - Phone:615-329-5144
Practice Address - Fax:615-284-2751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3377909Medicare ID - Type Unspecified