MEDICARE: OSA-HA MEDICAL PRACTICE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1780852988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSA-HA MEDICAL PRACTICE, P.C.

Provider Business Mailing Address
First Line	:	81 MEMORIAL DR
Second Line	:
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2401
Country	:	US
Telephone Number	:	931-967-7171
Fax Number	:	931-967-3131

Provider Business Practice Location Address
First Line	:	81 MEMORIAL DR
Second Line	:
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2401
Country	:	US
Telephone Number	:	931-967-7171
Fax Number	:	931-967-3131

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. HAMILTON OSASERE EMOKPAE
Credential	:	M.D.
Telephone Number	:	931-967-7171

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	02/11/2008

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