Provider Demographics
NPI:1114175585
Name:MID-SOUTH ORTHOPEDIC HOSPITALISTS LLC
Entity Type:Organization
Organization Name:MID-SOUTH ORTHOPEDIC HOSPITALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-885-5522
Mailing Address - Street 1:PO BOX 952192
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75395-0001
Mailing Address - Country:US
Mailing Address - Phone:330-470-3700
Mailing Address - Fax:330-497-7940
Practice Address - Street 1:7535 AIRWAYS BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5834
Practice Address - Country:US
Practice Address - Phone:662-349-0248
Practice Address - Fax:662-349-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty