Provider Demographics
NPI:1568655132
Name:MADISON HMA PHYSICIAN MANAGEMENT, INC.-CRNAS
Entity Type:Organization
Organization Name:MADISON HMA PHYSICIAN MANAGEMENT, INC.-CRNAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-376-1100
Mailing Address - Street 1:1421 E PEACE ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-4938
Mailing Address - Country:US
Mailing Address - Phone:601-859-1331
Mailing Address - Fax:
Practice Address - Street 1:1421 E PEACE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-4938
Practice Address - Country:US
Practice Address - Phone:601-859-1331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty