Healthcare Provider Details

I. General information

NPI: 1992868509
Provider Name (Legal Business Name): HOSPITALMD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 HIGHWAY 13 S
MORTON MS
39117-3353
US

IV. Provider business mailing address

401 CAMDEN COPE P.O. BOX 2087
PEACHTREE CITY GA
30269-2455
US

V. Phone/Fax

Practice location:
  • Phone: 601-732-1069
  • Fax: 601-732-8978
Mailing address:
  • Phone: 678-364-1422
  • Fax: 678-364-1423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES HAROLD BURNETTE
Title or Position: PRESIDENT
Credential:
Phone: 678-364-1422