Provider Demographics
NPI:1053935437
Name:CVC PLLC
Entity type:Organization
Organization Name:CVC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:KURBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-307-8888
Mailing Address - Street 1:58 MURRAY GUARD DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3661
Mailing Address - Country:US
Mailing Address - Phone:731-513-5701
Mailing Address - Fax:877-670-6150
Practice Address - Street 1:58 MURRAY GUARD DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3661
Practice Address - Country:US
Practice Address - Phone:731-513-5701
Practice Address - Fax:877-670-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty