Provider Demographics
NPI:1619201043
Name:ALLIANCE HEALTH PARTNERS LLC
Entity Type:Organization
Organization Name:ALLIANCE HEALTH PARTNERS LLC
Other - Org Name:TRI LAKES MEDICAL CENTER HOSPITALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAVENS
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:662-563-5611
Mailing Address - Street 1:303 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-8608
Mailing Address - Country:US
Mailing Address - Phone:662-563-5611
Mailing Address - Fax:662-563-0155
Practice Address - Street 1:303 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-8608
Practice Address - Country:US
Practice Address - Phone:662-563-5611
Practice Address - Fax:662-563-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13-287208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty