Basic Information
| Provider Information | |||||||||
| NPI: | 1538488564 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEARTLAND CARDIOLOGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5677 SCIOTO DARBY RD | ||||||||
| Address2: | |||||||||
| City: | HILLIARD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430261391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145291185 | ||||||||
| FaxNumber: | 6145290137 | ||||||||
| Practice Location | |||||||||
| Address1: | 5677 SCIOTO DARBY RD | ||||||||
| Address2: | |||||||||
| City: | HILLIARD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430261391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145291185 | ||||||||
| FaxNumber: | 6145290137 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2010 | ||||||||
| LastUpdateDate: | 06/01/2010 | ||||||||
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| AuthorizedOfficialLastName: | EVANS | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6145291185 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 34-005271 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.