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General NPI Number Information
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NPI Number | 1225092547
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Entity Type | Organization
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Legal Business Name | HOHENWALD MEDICAL CENTER
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 10/08/2007
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Provider Practice Location Address
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Address Line | 20 S PARK ST
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City | HOHENWALD
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State | TN
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Zip | 38462-1413
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Country | US
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Telephone | 931-796-7960
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Fax | 931-796-7790
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Provider Business Mailing Address
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Address Line | PO BOX 5
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City | HOHENWALD
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State | TN
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Zip | 38462-0005
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Country | US
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Telephone | 931-796-7960
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Fax | 931-796-7790
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Authorized Official
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Title or Position | PARTNER
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Name | MICHAEL PARKER
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Credential |
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Telephone | 931-796-7960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA0000000781
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0000021337
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License Number State | TN
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