Healthcare Provider Details
I. General information
NPI: 1447433222
Provider Name (Legal Business Name): GADSDEN HMA PHYSICIAN MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2007
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 BAY ST SUITE 301
GADSDEN AL
35901-5265
US
IV. Provider business mailing address
PO BOX 689022
FRANKLIN TN
37068-9022
US
V. Phone/Fax
- Phone: 256-546-4868
- Fax:
- Phone: 615-465-7000
- Fax: 615-628-6877
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
P
WRIGHT
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 615-465-7587