Provider Demographics
NPI:1972819035
Name:AMORY HMA PHYSICIAN MGMT LLC
Entity Type:Organization
Organization Name:AMORY HMA PHYSICIAN MGMT LLC
Other - Org Name:AMORY UROLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-256-7112
Mailing Address - Street 1:1127 EARL FRYE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-5516
Mailing Address - Country:US
Mailing Address - Phone:662-256-6191
Mailing Address - Fax:662-256-6194
Practice Address - Street 1:1127 EARL FRYE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-5516
Practice Address - Country:US
Practice Address - Phone:662-256-6191
Practice Address - Fax:662-256-6194
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11876208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty