Basic Information
| Provider Information | |||||||||
| NPI: | 1922172626 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL SPECIALISTS OF DUBLIN, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6501 PEAKE RD | ||||||||
| Address2: | #700 | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312108042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4784741769 | ||||||||
| FaxNumber: | 4784749034 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 INDUSTRIAL BLVD | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310212981 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4784741769 | ||||||||
| FaxNumber: | 4784749034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TUCK | ||||||||
| AuthorizedOfficialFirstName: | R STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 4784741769 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.