Basic Information
| Provider Information | |||||||||
| NPI: | 1811224009 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL CARE CONSULTANTS OF KOSCIUSKO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17304 PRESTON RD | ||||||||
| Address2: | SUITE 555 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752525618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669318882 | ||||||||
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| Practice Location | |||||||||
| Address1: | 220 HIGHWAY 12 W | ||||||||
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| City: | KOSCIUSKO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390903208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622894322 | ||||||||
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| ProviderEnumerationDate: | 11/09/2009 | ||||||||
| LastUpdateDate: | 11/09/2009 | ||||||||
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| AuthorizedOfficialLastName: | WEISS | ||||||||
| AuthorizedOfficialFirstName: | RON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO / PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8669318882 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.