Provider Demographics
NPI:1992817365
Name:KNOX CARDIOLOGY ASSOCIATES, INC.
Entity type:Organization
Organization Name:KNOX CARDIOLOGY ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-397-0108
Mailing Address - Street 1:7 WOODLAKE TRL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-8103
Mailing Address - Country:US
Mailing Address - Phone:740-397-0108
Mailing Address - Fax:740-397-0800
Practice Address - Street 1:7 WOODLAKE TRL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-8103
Practice Address - Country:US
Practice Address - Phone:740-397-0108
Practice Address - Fax:740-397-0800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNOX CARDIOLOGY ASSOCIATES,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2499318Medicaid
CF1310OtherRAILROAD MEDICARE
OH0791764Medicaid
OH0791764Medicaid
OH9207131Medicare PIN