Provider Demographics
NPI:1215115902
Name:MOORESVILLE HMA PHYSICIAN MANAGEMENT INC
Entity type:Organization
Organization Name:MOORESVILLE HMA PHYSICIAN MANAGEMENT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-598-3131
Mailing Address - Street 1:131 MEDICAL PARK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8522
Mailing Address - Country:US
Mailing Address - Phone:704-664-5633
Mailing Address - Fax:704-664-5631
Practice Address - Street 1:131 MEDICAL PARK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8522
Practice Address - Country:US
Practice Address - Phone:704-664-5633
Practice Address - Fax:704-664-5631
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH MANAGEMENT ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-05
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37944207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00418919OtherRR MEDICARE
NC5705330001OtherDME
NC4329OtherPARTNERS
NC5903186Medicaid
NC4329OtherPARTNERS