Provider Demographics
NPI:1851609325
Name:CMC HOSPITALIST GROUP, LLC
Entity Type:Organization
Organization Name:CMC HOSPITALIST GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:931-456-9434
Mailing Address - Street 1:421 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-5048
Mailing Address - Country:US
Mailing Address - Phone:931-456-9434
Mailing Address - Fax:931-456-5061
Practice Address - Street 1:421 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5048
Practice Address - Country:US
Practice Address - Phone:931-456-9434
Practice Address - Fax:931-456-5061
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUMBERLAND MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty