Provider Demographics
NPI:1104911742
Name:CARDIOLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-431-1022
Mailing Address - Street 1:425 W 3RD AVENUE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701
Mailing Address - Country:US
Mailing Address - Phone:229-431-1022
Mailing Address - Fax:229-903-1369
Practice Address - Street 1:425 W 3RD AVENUE
Practice Address - Street 2:SUITE 600
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701
Practice Address - Country:US
Practice Address - Phone:229-431-1022
Practice Address - Fax:229-903-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
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
GA55000806AMedicaid
GA55000806AMedicaid