Organization
HIDDEN VALLEY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA ARWOOD (DIRECTOR PHYSICIAN OPERATIONS)
(615) 628-6038
Entity
Organization
Contact information
Practice address
101 RIVERSTONE VIS STE 300, BLUE RIDGE, GA 30513-6683
(706) 946-4206
(706) 946-4289
Mailing address
101 RIVERSTONE VIS STE 300, BLUE RIDGE, GA 30513-6683
(706) 946-4206
(706) 946-4289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031398R
—
GA
05
—
5908360
—
NC
05
—
776553734B
—
GA
05
—
890160U
—
NC
01
—
CI 1930
RAILROAD MEDICARE
GA
Enumeration date
05/27/2005
Last updated
10/16/2018
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