Provider Demographics
NPI:1497242366
Name:MOUNTAIN VIEW PHYSICIAN PRACTICE INC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW PHYSICIAN PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAMUS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-855-1620
Mailing Address - Street 1:114 N DUNCAN ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-3100
Mailing Address - Country:US
Mailing Address - Phone:931-879-9017
Mailing Address - Fax:
Practice Address - Street 1:114 N DUNCAN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3100
Practice Address - Country:US
Practice Address - Phone:931-879-9017
Practice Address - Fax:931-879-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty