1306860978 NPI number — HOSPITAL MEDICINE GROUP INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306860978 NPI number — HOSPITAL MEDICINE GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL MEDICINE GROUP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306860978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 261164
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-289-8971
Provider Business Mailing Address Fax Number:
337-289-8970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 FLORIDA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-289-8971
Provider Business Practice Location Address Fax Number:
337-289-8970
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VIATOR
Authorized Official First Name:
DIONNE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SR. VP AND CFO
Authorized Official Telephone Number:
225-237-1540

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1448478 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DE4744 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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