Healthcare Provider Details

I. General information

NPI: 1275585267
Provider Name (Legal Business Name): OCOEE HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 CHAMBLISS AVE NW
CLEVELAND TN
37311-3847
US

IV. Provider business mailing address

2305 CHAMBLISS AVE NW
CLEVELAND TN
37311-3847
US

V. Phone/Fax

Practice location:
  • Phone: 423-559-6000
  • Fax: 423-559-6653
Mailing address:
  • Phone: 423-559-6000
  • Fax: 423-559-6653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM S HUSSEY
Title or Position: GROUP VP
Credential:
Phone: 615-465-7000