MEDICARE: SHERWOOD PARK PEDIATRICS, P.C.

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
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1578657672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERWOOD PARK PEDIATRICS, P.C.

Provider Business Mailing Address
First Line	:	1216 SHERWOOD PARK DR NE
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3445
Country	:	US
Telephone Number	:	770-532-9958
Fax Number	:	770-532-8844

Provider Business Practice Location Address
First Line	:	1216 SHERWOOD PARK DR NE
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3445
Country	:	US
Telephone Number	:	770-532-9958
Fax Number	:	770-532-8844

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES MICHAEL HOSFORD
Credential	:	M.D.
Telephone Number	:	770-532-9958

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/22/2020

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