Basic Information
| Provider Information | |||||||||
| NPI: | 1568916492 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREMIER INPATIENT PARTNERS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2338 IMMOKALEE RD | ||||||||
| Address2: | SUITE 186 | ||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341101445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393302933 | ||||||||
| FaxNumber: | 2393302933 | ||||||||
| Practice Location | |||||||||
| Address1: | 2338 IMMOKALEE RD | ||||||||
| Address2: | SUITE 186 | ||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341101445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393302933 | ||||||||
| FaxNumber: | 2393302933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2016 | ||||||||
| LastUpdateDate: | 03/14/2018 | ||||||||
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| AuthorizedOfficialLastName: | MARSH | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2393302933 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.