Provider Demographics
NPI:1881890598
Name:CARDIOLOGY ASSOCIATES OF NATCHEZ
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF NATCHEZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING
Authorized Official - Phone:225-924-9827
Mailing Address - Street 1:140 JEFFERSON DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5104
Mailing Address - Country:US
Mailing Address - Phone:601-304-9718
Mailing Address - Fax:601-304-9637
Practice Address - Street 1:140 JEFFERSON DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5104
Practice Address - Country:US
Practice Address - Phone:601-304-9718
Practice Address - Fax:601-304-9637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1598707150OtherNPI
MS37396OtherMS LICENSE NUMBER
MS37396OtherMS LICENSE NUMBER