Provider Demographics
NPI:1902099831
Name:JOSEPH S. HURST, M.D.,P.C.
Entity Type:Organization
Organization Name:JOSEPH S. HURST, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-5911
Mailing Address - Street 1:2101 NORTH AVE
Mailing Address - Street 2:STE B
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8806
Mailing Address - Country:US
Mailing Address - Phone:706-507-5911
Mailing Address - Fax:706-507-5913
Practice Address - Street 1:2101 NORTH AVE
Practice Address - Street 2:STE B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8806
Practice Address - Country:US
Practice Address - Phone:706-507-5911
Practice Address - Fax:706-507-5913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000674693LMedicaid
GAG06173Medicare UPIN
GA000674693LMedicaid
GAGRP7660Medicare PIN