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General NPI Number Information
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NPI Number | 1689663007
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Entity Type | Organization
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Legal Business Name | THE GOOD SHEPHERD HOSPITAL, INC.
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 700 E MARSHALL AVE
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City | LONGVIEW
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State | TX
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Zip | 75601-5580
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Country | US
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Telephone | 903-315-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E MARSHALL AVE
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City | LONGVIEW
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State | TX
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Zip | 75601-5580
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Country | US
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Telephone | 903-315-2000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. NORMAN TODD HANCOCK
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Credential |
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Telephone | 903-315-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology 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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | TX
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