Provider Demographics
NPI:1548262587
Name:CARDIOTHORACIC SURGERY OF CHARLESTON
Entity type:Organization
Organization Name:CARDIOTHORACIC SURGERY OF CHARLESTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-720-8490
Mailing Address - Street 1:125 DOUGHTY ST
Mailing Address - Street 2:SUITE 690
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5736
Mailing Address - Country:US
Mailing Address - Phone:843-720-8490
Mailing Address - Fax:843-727-3602
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:SUITE 690
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5736
Practice Address - Country:US
Practice Address - Phone:843-720-8490
Practice Address - Fax:843-727-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty