Organization
HOSPITALMD OF SPARTA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES H BURNETTE (PRESIDENT)
(678) 364-1422
Entity
Organization
Contact information
Practice address
818 E BROADWAY ST, SPARTA, IL 62286-1820
(618) 443-2177
Mailing address
401 CAMDEN COPE, PO BOX 2087, PEACHTREE CITY, GA 30269-2455
(678) 364-1422
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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