Healthcare Provider Details

I. General information

NPI: 1922594431
Provider Name (Legal Business Name): HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PHIPPS LANE
PARIS IL
61944-2966
US

IV. Provider business mailing address

727 E COURT ST
PARIS IL
61944-2460
US

V. Phone/Fax

Practice location:
  • Phone: 217-463-4340
  • Fax:
Mailing address:
  • Phone: 217-465-8411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: OLIVER SMITH
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 217-465-4141