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NPI Code Detail

MEDICARE: VENTURE HOSPITALIST, LLC

MEDICARE: VENTURE HOSPITALIST, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician

General Provider Information

NPI Number : 1346728508
Entity Type Code : Organization
Provider Name (Legal Business Name) : VENTURE HOSPITALIST, LLC
Provider Business Mailing Address
First Line : 110 PIONEER WAY
Second Line :
City : MAGEE
State : MS
Zip : 39111-5501
Country : US
Telephone Number : 601-849-6440
Fax Number :
Provider Business Practice Location Address
First Line : 1135 ROYAL ST APT 2
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70116-2717
Country : US
Telephone Number : 601-955-1977
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : KIM MCNULTY
Credential :
Telephone Number : 601-955-1977
Provider Enumeration Date : 07/31/2018
Last Update Date : 07/31/2018

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Directions to “VENTURE HOSPITALIST, LLC ” Practice Location

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