Provider Demographics
NPI:1013319144
Name:DOCTORS HOSPITAL PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:DOCTORS HOSPITAL PHYSICIAN SERVICES LLC
Other - Org Name:AFFINITY GASTROENTEROLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7587
Mailing Address - Street 1:3722 DRESSLER RD NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2700
Mailing Address - Country:US
Mailing Address - Phone:330-479-9000
Mailing Address - Fax:330-477-5805
Practice Address - Street 1:3722 DRESSLER RD NW
Practice Address - Street 2:SUITE B
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2700
Practice Address - Country:US
Practice Address - Phone:330-479-9000
Practice Address - Fax:330-477-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy