Provider Demographics
NPI:1255500112
Name:MEDICAL HOUSE CALLS
Entity Type:Organization
Organization Name:MEDICAL HOUSE CALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:DUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:770-856-3975
Mailing Address - Street 1:50 BARRETT PKWY
Mailing Address - Street 2:1200-339
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3300
Mailing Address - Country:US
Mailing Address - Phone:770-856-3975
Mailing Address - Fax:770-485-4737
Practice Address - Street 1:4749 LIMESTONE LN NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-6484
Practice Address - Country:US
Practice Address - Phone:770-856-3975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty