Provider Demographics
NPI:1083859193
Name:MOSTHOUSE INC
Entity type:Organization
Organization Name:MOSTHOUSE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TURKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-432-9755
Mailing Address - Street 1:3201 S COBB DR SE
Mailing Address - Street 2:SUITE # D-1
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4190
Mailing Address - Country:US
Mailing Address - Phone:770-432-9755
Mailing Address - Fax:
Practice Address - Street 1:3201 S COBB DR SE
Practice Address - Street 2:SUITE # D-1
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4190
Practice Address - Country:US
Practice Address - Phone:770-432-9755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN039884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty