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General NPI Number Information
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NPI Number | 1073516621
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Entity Type | Organization
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Legal Business Name | HIDDEN VALLEY MEDICAL CENTER INC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 10/16/2018
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Provider Practice Location Address
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Address Line | 101 RIVERSTONE VIS STE 300
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City | BLUE RIDGE
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State | GA
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Zip | 30513-6683
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Country | US
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Telephone | 706-946-4206
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Fax | 706-946-4289
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Provider Business Mailing Address
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Address Line | 101 RIVERSTONE VIS STE 300
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City | BLUE RIDGE
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State | GA
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Zip | 30513-6683
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Country | US
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Telephone | 706-946-4206
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Fax | 706-946-4289
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Authorized Official
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Title or Position | DIRECTOR PHYSICIAN OPERATIONS
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Name | SOPHIA ARWOOD
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Credential |
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Telephone | 615-628-6038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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