Healthcare Provider Details

I. General information

NPI: 1508897224
Provider Name (Legal Business Name): WINDER HMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 N BROAD ST
WINDER GA
30680-2150
US

IV. Provider business mailing address

316 N BROAD ST
WINDER GA
30680-2150
US

V. Phone/Fax

Practice location:
  • Phone: 770-867-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY PARRY
Title or Position: SR VP AND GENERAL COUNSEL
Credential: ESQ
Phone: 239-598-3176