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General NPI Number Information
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NPI Number | 1346373180
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Entity Type | Organization
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Legal Business Name | THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 541 HISTORIC HWY 441 N
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City | DEMOREST
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State | GA
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Zip | 30535-4528
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Country | US
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Telephone | 706-754-2273
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Fax | 706-754-7300
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Provider Business Mailing Address
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Address Line | 396 HISTORIC HIGHWAY 441 N
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City | DEMOREST
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State | GA
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Zip | 30535
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Country | US
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Telephone | 706-754-2273
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Fax | 706-754-7300
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Authorized Official
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Title or Position | SR. VP OF FINANCE
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Name | MR. JAMES A PETERSON
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Credential |
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Telephone | 706-754-3113
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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 | 4705360
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License Number State | GA
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