MEDICARE: GAINESVILLE HOSPITAL DISTRICT

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	:	1750652756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAINESVILLE HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1900 HOSPITAL BLVD
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-2002
Country	:	US
Telephone Number	:	940-612-8616
Fax Number	:	940-612-8601

Provider Business Practice Location Address
First Line	:	1902 HOSPITAL BLVD
Second Line	:	SUITE G
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-2007
Country	:	US
Telephone Number	:	940-612-8770
Fax Number	:	940-612-8779

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. JULIE JANAE HALL
Credential	:
Telephone Number	:	940-612-8616

Provider Enumeration Date	:	01/23/2012
Last Update Date	:	01/23/2012

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