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SOUTHPORT CARDIOVASCULAR SURGEONS LLC
NPI 1063894723
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Paddock Lake, WI

Active since June 18, 2015
7137 236TH AVENUE, #103, PADDOCK LAKE, WI 53168(262) 843-4422 Get Directions Write a Review

NPPES record last updated: June 18, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southport Cardiovascular Surgeons Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHPORT CARDIOVASCULAR SURGEONS LLC (NPI 1063894723) is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Paddock Lake, Wisconsin and active in the NPI registry since June 2015. The organization lists Christopher Stone, Owner, as its authorized official.

NPPES Registry Identity

NPI1063894723
Entity TypeOrganization
Primary Taxonomy208G00000X
Legal Business NameSOUTHPORT CARDIOVASCULAR SURGEONS LLC
Location Address7137 236TH AVENUE, #103Paddock Lake, WI 53168
Mailing Address7137 236th Avenue, #103Paddock Lake, WI 53168
Phone(262) 843-4422
Organization SubpartNo
Authorized OfficialChristopher StoneOwner · (262) 843-4422
Enumeration DateJune 18, 2015
✔ NPI 1063894723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in WI · 38886
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
7137 236TH AVENUE, Paddock Lake, WI 53168
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMES CHARLES FULMER D.D.S.
Dentist (General Practice)
7137 236TH AVENUE, SUITE 108
SALEM, WI 53168
Kenosha County (262) 843-4643

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southport Cardiovascular Surgeons LLC's NPI number?

The NPI number for Southport Cardiovascular Surgeons LLC is 1063894723. It was assigned to this organization in the NPPES registry on June 18, 2015.

Where is Southport Cardiovascular Surgeons LLC located?

Southport Cardiovascular Surgeons LLC is located at 7137 236th Avenue #103, Paddock Lake, WI 53168. The listed phone number is (262) 843-4422.

What is Southport Cardiovascular Surgeons LLC's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

When was this NPI record last updated?

The NPPES record for Southport Cardiovascular Surgeons LLC was last updated on June 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.