Provider Demographics
NPI:1215149273
Name:HEARTLAND INTERNAL MEDICINE PLLC.
Entity type:Organization
Organization Name:HEARTLAND INTERNAL MEDICINE PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:R
Authorized Official - Last Name:QUADRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-312-8564
Mailing Address - Street 1:425 E EAGLE PASS RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8576
Mailing Address - Country:US
Mailing Address - Phone:270-312-8564
Mailing Address - Fax:
Practice Address - Street 1:914 N DIXIE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2520
Practice Address - Country:US
Practice Address - Phone:270-769-0892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty