Provider Demographics
NPI:1003096371
Name:HOSPITALMD OF CARO IP, INC.
Entity Type:Organization
Organization Name:HOSPITALMD OF CARO IP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-631-8478
Mailing Address - Street 1:200 WESTPARK DR
Mailing Address - Street 2:SUITE 325
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3534
Mailing Address - Country:US
Mailing Address - Phone:770-631-8478
Mailing Address - Fax:770-631-8473
Practice Address - Street 1:401 N HOOPER ST
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1476
Practice Address - Country:US
Practice Address - Phone:989-673-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty