=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922594431
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2018
-----------------------------------------------------
Last Update Date | 12/16/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 PHIPPS LANE
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61944-2966
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-463-4340
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 727 E COURT ST
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61944-2460
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-465-8411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | OLIVER SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 217-465-4141
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------