Healthcare Provider Details

I. General information

NPI: 1457885105
Provider Name (Legal Business Name): HCC OF BATESVILLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 MEDICAL CENTER DR
BATESVILLE MS
38606-8608
US

IV. Provider business mailing address

17304 PRESTON RD STE 1400
DALLAS TX
75252-5633
US

V. Phone/Fax

Practice location:
  • Phone: 662-563-5611
  • Fax:
Mailing address:
  • Phone: 972-932-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: RON WEISS
Title or Position: CEO
Credential:
Phone: 972-934-3200