Provider Demographics
NPI:1841252574
Name:CARDIOVASCULAR & THORACIC SURGERY ASSOC
Entity type:Organization
Organization Name:CARDIOVASCULAR & THORACIC SURGERY ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RANSOM
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:501-223-2860
Mailing Address - Street 1:9601 LILE DR
Mailing Address - Street 2:STE 330
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6325
Mailing Address - Country:US
Mailing Address - Phone:501-223-2860
Mailing Address - Fax:501-223-2258
Practice Address - Street 1:9601 LILE DR
Practice Address - Street 2:STE 330
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6325
Practice Address - Country:US
Practice Address - Phone:501-223-2860
Practice Address - Fax:501-223-2258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR57511Medicare ID - Type Unspecified