Provider Demographics
NPI:1982351235
Name:INTERNAL MEDICINE & PEDIATRIC CONSULTANTS
Entity Type:Organization
Organization Name:INTERNAL MEDICINE & PEDIATRIC CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-276-3214
Mailing Address - Street 1:PO BOX 8608
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36304-0608
Mailing Address - Country:US
Mailing Address - Phone:334-796-9171
Mailing Address - Fax:
Practice Address - Street 1:1108 ROSS CLARK CIR FL 4
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3022
Practice Address - Country:US
Practice Address - Phone:342-763-2143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty