Provider Demographics
NPI:1902048010
Name:LINCOLN MEDICAL CENTER HOSPITALIST
Entity Type:Organization
Organization Name:LINCOLN MEDICAL CENTER HOSPITALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GROCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-438-7471
Mailing Address - Street 1:106 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-2684
Mailing Address - Country:US
Mailing Address - Phone:931-438-7482
Mailing Address - Fax:931-438-7447
Practice Address - Street 1:106 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-2684
Practice Address - Country:US
Practice Address - Phone:931-438-7482
Practice Address - Fax:931-438-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty