Provider Demographics
NPI:1376897868
Name:NATCHEZ HMA PHYSICIAN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:NATCHEZ HMA PHYSICIAN MANAGEMENT, LLC
Other - Org Name:CONCORDIA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7587
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:615-628-6877
Practice Address - Street 1:900 CARTER ST
Practice Address - Street 2:SUITE A
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3208
Practice Address - Country:US
Practice Address - Phone:318-336-4780
Practice Address - Fax:318-336-4783
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH MANAGEMENT ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-05
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC03612Medicare PIN