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NPI Code Detail

MEDICARE: HOSPITALMD OF WINONA, INC.

MEDICARE: HOSPITALMD OF WINONA, INC.
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1659412039
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOSPITALMD OF WINONA, INC.
Provider Business Mailing Address
First Line : 401 CAMDEN COPE
Second Line : P.O. BOX 2087
City : PEACHTREE CITY
State : GA
Zip : 30269-2455
Country : US
Telephone Number : 678-364-1422
Fax Number : 678-364-1423
Provider Business Practice Location Address
First Line : 409 TYLER HOLMES DR
Second Line :
City : WINONA
State : MS
Zip : 38967-1521
Country : US
Telephone Number : 662-283-4114
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JAMES HAROLD BURNETTE
Credential :
Telephone Number : 678-364-1422
Provider Enumeration Date : 02/09/2007
Last Update Date : 08/22/2020

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Practice Fax: 662-283-4640

Directions to “HOSPITALMD OF WINONA, INC. ” Practice Location

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