Healthcare Provider Details

I. General information

NPI: 1255919478
Provider Name (Legal Business Name): HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 S 6TH ST
MARSHALL IL
62441-1829
US

IV. Provider business mailing address

721 E COURT ST
PARIS IL
61944-2460
US

V. Phone/Fax

Practice location:
  • Phone: 217-465-4141
  • Fax:
Mailing address:
  • Phone: 217-465-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARTIN ADAMS
Title or Position: VP OF FINANCE AND CFO
Credential:
Phone: 217-466-4246