Healthcare Provider Details

I. General information

NPI: 1811224009
Provider Name (Legal Business Name): HOSPITAL CARE CONSULTANTS OF KOSCIUSKO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HIGHWAY 12 W
KOSCIUSKO MS
39090-3208
US

IV. Provider business mailing address

17304 PRESTON RD SUITE 555
DALLAS TX
75252-5618
US

V. Phone/Fax

Practice location:
  • Phone: 662-289-4322
  • Fax:
Mailing address:
  • Phone: 866-931-8882
  • 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: RON WEISS
Title or Position: CEO / PRESIDENT
Credential:
Phone: 866-931-8882