Provider Demographics
NPI:1073835435
Name:MORRISTOWN HAMBLEN HOSPITAL
Entity Type:Organization
Organization Name:MORRISTOWN HAMBLEN HOSPITAL
Other - Org Name:ADVANCED WOMEN'S HEALTH SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:IVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-587-8700
Mailing Address - Street 1:DEPT 888229
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8229
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6188
Practice Address - Street 1:1633 W MORRIS BLVD
Practice Address - Street 2:STE A
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3875
Practice Address - Country:US
Practice Address - Phone:423-587-8700
Practice Address - Fax:423-581-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518350Medicaid
TN103G705726Medicare PIN