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Contact Information

FAIRVIEW HEIGHTS MEDICAL GROUP SC
4230 LINCOLNSHIRE DR STE A
MOUNT VERNON, IL62864-2189
 Phone: 618-241-1833
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for FAIRVIEW HEIGHTS MEDICAL GROUP SC

NPI # 1326171158
LBN Legal business name FAIRVIEW HEIGHTS MEDICAL GROUP SC
Authorized official RAYMOND DAVIDSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/13/2007
Last updated 01/07/2008 - About 18 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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