Provider Demographics
NPI:1609885532
Name:OSVALDO HANS MD
Entity Type:Organization
Organization Name:OSVALDO HANS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF PHYSICIAN OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-287-6913
Mailing Address - Street 1:100 NORMAN RD
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9372
Mailing Address - Country:US
Mailing Address - Phone:662-286-6997
Mailing Address - Fax:662-286-6148
Practice Address - Street 1:100 NORMAN RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9372
Practice Address - Country:US
Practice Address - Phone:662-286-6997
Practice Address - Fax:662-286-6148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2009-06-12
Deactivation Date:2007-04-17
Deactivation Code:
Reactivation Date:2009-05-22
Provider Licenses
StateLicense IDTaxonomies
MS09558207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty