Basic Information
| Provider Information | |||||||||
| NPI: | 1649624255 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STV CARDIOTHORACIC SURGEONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 MEDICAL PARK DR E | ||||||||
| Address2: | BLDG 46, STE 310, FINANCE | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352353401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058385286 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3056 HEALTHY WAY STE 100 | ||||||||
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| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352432435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059302925 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2016 | ||||||||
| LastUpdateDate: | 10/27/2022 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | BRANDON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2058383766 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | VINCENTIAN VENTURES OF NORTH ALABAMA | ||||||||
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| NPICertificationDate: | 10/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.