Basic Information
| Provider Information | |||||||||
| NPI: | 1437260577 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIAC AND VASCULAR SURGEONS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9601 LILE DR | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012232860 | ||||||||
| FaxNumber: | 5019780036 | ||||||||
| Practice Location | |||||||||
| Address1: | 9601 LILE DR | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012232860 | ||||||||
| FaxNumber: | 5019780036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 10/16/2007 | ||||||||
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| AuthorizedOfficialLastName: | DAY | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5012232860 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | E1620 | AR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.