Provider Demographics
NPI:1538390935
Name:IN HOME PHYSICIAN SERVICES LLC
Entity type:Organization
Organization Name:IN HOME PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:W
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-788-0455
Mailing Address - Street 1:1320 S ORLANDO AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5556
Mailing Address - Country:US
Mailing Address - Phone:407-788-0455
Mailing Address - Fax:407-389-0931
Practice Address - Street 1:1320 S ORLANDO AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5556
Practice Address - Country:US
Practice Address - Phone:407-788-0455
Practice Address - Fax:407-389-0931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty