Provider Demographics
NPI:1780096263
Name:HEART INSTITUTE OF ANDALUSIA
Entity type:Organization
Organization Name:HEART INSTITUTE OF ANDALUSIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-222-4327
Mailing Address - Street 1:215 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5354
Mailing Address - Country:US
Mailing Address - Phone:334-222-4327
Mailing Address - Fax:334-222-4333
Practice Address - Street 1:215 MEDICAL PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5354
Practice Address - Country:US
Practice Address - Phone:334-222-4327
Practice Address - Fax:334-222-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty