Provider Demographics
NPI:1760605851
Name:JMH MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:JMH MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOLLINGSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-291-8400
Mailing Address - Street 1:867 LEE RD 248
Mailing Address - Street 2:P.O. BOX 1417
Mailing Address - City:SMITHS STATION
Mailing Address - State:AL
Mailing Address - Zip Code:36877
Mailing Address - Country:US
Mailing Address - Phone:334-291-8400
Mailing Address - Fax:334-291-8409
Practice Address - Street 1:867 LEE RD 248
Practice Address - Street 2:
Practice Address - City:SMITHS STATION
Practice Address - State:AL
Practice Address - Zip Code:36877
Practice Address - Country:US
Practice Address - Phone:334-291-8400
Practice Address - Fax:334-291-8409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO497207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1223358OtherCIGNA
AL51511654OtherBCBS OF AL
GA08BBXFJMedicare ID - Type Unspecified
AL1223358OtherCIGNA