Provider Demographics
NPI:1194962969
Name:SHELBYVILLE CARDIOLOGY, LLC
Entity type:Organization
Organization Name:SHELBYVILLE CARDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-5135
Mailing Address - Street 1:2839 HIGHWAY 231 N
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7447
Mailing Address - Country:US
Mailing Address - Phone:931-685-5533
Mailing Address - Fax:931-685-5544
Practice Address - Street 1:2839 HIGHWAY 231 N
Practice Address - Street 2:SUITE 208
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7447
Practice Address - Country:US
Practice Address - Phone:931-685-5533
Practice Address - Fax:931-685-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty