Basic Information
Provider Information
NPI: 1083046684
EntityType: 2
ReplacementNPI:  
OrganizationName: HAMILTON MEDICAL CENTER
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 1200 MEMORIAL DR
Address2:  
City: DALTON
State: GA
PostalCode: 307202529
CountryCode: US
TelephoneNumber: 7062726000
FaxNumber:  
Practice Location
Address1: 1200 MEMORIAL DR
Address2:  
City: DALTON
State: GA
PostalCode: 307202529
CountryCode: US
TelephoneNumber: 7062726000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2013
LastUpdateDate: 08/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: EDGEMAN
AuthorizedOfficialFirstName: MELINDA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF WOMEN'S SERVICES
AuthorizedOfficialTelephone: 7062726773
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: RN, MSN, APRN , BC
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000XRN166498GAY HospitalsGeneral Acute Care Hospital 

No ID Information.


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