Basic Information
| Provider Information | |||||||||
| NPI: | 1306860978 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL MEDICINE GROUP INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 261164 | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372898971 | ||||||||
| FaxNumber: | 3372898970 | ||||||||
| Practice Location | |||||||||
| Address1: | 3600 FLORIDA BLVD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372898971 | ||||||||
| FaxNumber: | 3372898970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 05/05/2008 | ||||||||
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| AuthorizedOfficialLastName: | VIATOR | ||||||||
| AuthorizedOfficialFirstName: | DIONNE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | SR. VP AND CFO | ||||||||
| AuthorizedOfficialTelephone: | 2252371540 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1448478 | 05 | LA | MEDICAID | DE4744 | 01 | LA | RAILROAD MEDICARE | OTHER |