Provider Demographics
NPI:1932504834
Name:HCH PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:HCH PHYSICIAN SERVICES LLC
Other - Org Name:GADSDEN COUNTY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANTZ
Authorized Official - Middle Name:C
Authorized Official - Last Name:HERCULE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:850-662-4070
Mailing Address - Street 1:PO BOX 1618
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32353-1618
Mailing Address - Country:US
Mailing Address - Phone:850-662-4070
Mailing Address - Fax:850-662-4047
Practice Address - Street 1:809 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-2623
Practice Address - Country:US
Practice Address - Phone:850-662-4070
Practice Address - Fax:850-662-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN242208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty