Basic Information
| Provider Information | |||||||||
| NPI: | 1073085189 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEART CENTER USA INCORPORATED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4901 RALEIGH COMMON DR | ||||||||
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| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381282478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018210338 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6500 KIRBY GATE BLVD | ||||||||
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| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381192673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012893727 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2018 | ||||||||
| LastUpdateDate: | 12/31/2018 | ||||||||
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| AuthorizedOfficialLastName: | WEINSTEIN | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | SETH | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9012893727 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.