EAST TEXAS MEDICAL CENTER CARTHAGE (NPI# 1649342650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649342650 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER CARTHAGE |
| Other Organization Name | ETMC FIRST PHYSICIAN CLINIC CARTHAGE |
| Practice Address |
702 Davis St Carthage TX 75633-1460 |
| Mailing Address |
Po Box 549 Carthage TX 75633-0549 |
| Practice Telephone | 9036933841 |
| Practice Fax Number | 9036944633 |
| Mailing Telephone | 9036933841 |
| Mailing Fax Number | 9036944633 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-10-26 |
| Authorized Official Name | MR. GARY M HUDSON (ADMINISTRATOR) |
| Authorized Official Telephone | 9036933841 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0005X |
Clinic/Center Specialization: Ambulatory Family Planning Facility |
Ambulatory Health Care Facilities | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS OF TEXAS | 00374K | 01 |
| Other Name | Type Code |
|---|---|
| ETMC First Physician Clinic Carthage | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740435957 | East Texas Medical Center Carthage | Clinic/Center | 304 Logansport St, Center, TX 75935-3521 | 2008-12-02 |
| 1629314539 | East Texas Medical Center Carthage | Clinic/Center | 305 Cottage Rd, Carthage, TX 75633-1511 | 2012-12-20 |
| 1144552308 | East Texas Medical Center Carthage | General Practice | 304 Logansport St, Center, TX 75935-3521 | 2010-02-12 |
| 1558693341 | East Texas Medical Center Carthage | Internal Medicine | 1743 Southview Cir, Center, TX 75935-9324 | 2010-02-04 |
| 1891969663 | East Texas Medical Center Carthage | Clinic/Center | 1743 Southview Cir, Center, TX 75935-9324 | 2008-04-14 |
| 1306912209 | East Texas Medical Center Carthage | Medicare Defined Swing Bed Unit | 409 Cottage Rd, Carthage, TX 75633-1466 | 2006-11-24 |
| 1215003116 | East Texas Medical Center Carthage | Clinic/Center | 409 Cottage Rd, Carthage, TX 75633-1466 | 2006-11-24 |
| 1023182086 | East Texas Medical Center Carthage | Clinic/Center | 409 Cottage Rd, Carthage, TX 75633-1466 | 2006-11-20 |
| 1932271947 | East Texas Medical Center Carthage | Internal Medicine | 409 Cottage Rd, Carthage, TX 75633-1466 | 2006-11-14 |
| 1801975107 | East Texas Medical Center Carthage | General Acute Care Hospital | 409 Cottage Rd, Carthage, TX 75633-1466 | 2006-11-06 |
| Street Address |
702 DAVIS ST |
| City | CARTHAGE |
| State | TX |
| Zip Code | 75633-1460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003811415 | John Francis Nielsen | Family Medicine | 702 Davis St, Ste 4, Carthage, TX 75633-1461 | 2005-06-14 |
| 1265675706 | Adam Duran | Family Medicine | 702 Davis St, Carthage, TX 75633-1460 | 2009-04-14 |
| 1629044300 | Robert C Wessman | Family Medicine | 702 Davis St, Ste 2, Carthage, TX 75633-1460 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508039348 | Assisted Living Concepts Inc | Assisted Living Facility | 513 North Adams, Carthage, TX 75633 | 2008-04-11 |
| 1770666208 | Prakash Malviya | Pediatrics | 409 Cottage Road, Etmc, Carthage, TX 75633 | 2006-10-20 |
| 1457448011 | Johnny Edwin Majors | Dentist | 103 North Sycamore, Carthage, TX 75633 | 2006-10-06 |
| 1740374164 | Clayton H. Brakeville | Physical Therapist | 107 S. Daniels St, Carthage, TX 75633 | 2006-10-02 |
| 1205927761 | Dennis D Golden Sr. | Optometrist | 105 Cottage Rd, Carthage, TX 75633 | 2006-09-27 |
| 1770685059 | Tom M Jones | Dentist | 311 West Sabine, Carthage, TX 75633 | 2006-09-05 |
| 1124037031 | Izzy Inc | Durable Medical Equipment & Medical Supplies | 106 N Shelby St, Carthage, TX 75633 | 2006-08-07 |
| 1699705756 | Iraj Roshan | Internal Medicine | 1519 W Panola St, Carthage, TX 75633 | 2006-07-04 |
| 1073504437 | Charles Deron Lewis | Durable Medical Equipment & Medical Supplies | 310 N Adams Street, Carthage, TX 75633 | 2005-11-03 |
| 1538157300 | Slp Carthage LLC | Skilled Nursing Facility | 701 S Market St, Carthage, TX 75633 | 2005-10-06 |
| Find all providers in zip 75633 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750944310 | Carthage Area Hospital, Inc. | Clinic/Center | 22075 Constitution Drive, Carthage, NY 13619 | 2019-04-19 |
| 1639678030 | Carthage Hospital, LLC | Clinic/Center | 702 North Davis Drive, Carthage, TX 75633-1460 | 2018-02-12 |
| 1194861260 | Baptist Medical Center - Leake, Inc. | Clinic/Center | 1100 Hwy 16 East, Carthage, MS 39051-3809 | 2007-01-29 |
| 1205887742 | Memorial Hospital Association | Clinic/Center | 403 S Adams St, Suite 239, Carthage, IL 62321-1624 | 2006-05-12 |
| 1588614002 | Memorial Hospital Association | Clinic/Center | 1450 N County Rd 2050, Carthage, IL 62321-0160 | 2006-05-12 |
| 1255984266 | Riverview Medical Center LLC | Clinic/Center | 133 Hospital Dr Ste 500, Carthage, TN 37030-4020 | 2019-07-18 |
| 1184128563 | Carthage Area Hospital Inc | Clinic/Center | 21957 Cole Rd, Carthage, NY 13619-9622 | 2018-03-21 |
| 1598264954 | Carthage Hospital, LLC | Clinic/Center | 409 Cottage Rd, Carthage, TX 75633-1466 | 2018-02-12 |
| 1407355860 | Carthage Hospital, LLC | Clinic/Center | 305 Cottage Rd, Carthage, TX 75633-1511 | 2018-02-12 |
| 1104229186 | Sgoh Acquisition, Inc. | Clinic/Center | 327 E Airport Dr, Carthage, MO 64836-3402 | 2014-10-03 |
| Find all providers in CARTHAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.