ECC CHATSWORTH DALTON MC, LLC NPI 1023292190

Emergency Medicine in Dalton, GA

NPI 1023292190 Organization Emergency Medicine

About ECC CHATSWORTH DALTON MC, LLC

Ecc Chatsworth Dalton Mc, Llc is a provider established in Dalton, Georgia specializing in emergency medicine. The NPI number of Ecc Chatsworth Dalton Mc, Llc is 1023292190 and was assigned on December 2007. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. Ecc Chatsworth Dalton Mc, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. John R Staley Jr. Md (President)

NPI

1023292190

Provider NameECC CHATSWORTH DALTON MC, LLC
Provider Location Address1200 MEMORIAL DRIVE DALTON, GA 30722
Provider Mailing AddressP O BOX 635919 CINCINNATI, OH 45263
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date12-24-2007
Last Update Date12-24-2007


Primary Taxonomy

Taxonomy Code207P00000X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Business Address

ECC CHATSWORTH DALTON MC, LLC
1200 MEMORIAL DRIVE
DALTON, GA
ZIP 30722
Phone: (706) 272-6158

Get Directions


Mailing Address

ECC CHATSWORTH DALTON MC, LLC
P O BOX 635919
CINCINNATI, OH
ZIP 45263
Phone:



Authorized Official

Authorized Official NameDR. JOHN R STALEY JR. MD
Authorized Official TitlePRESIDENT
Authorized Official Phone(888) 203-1274

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1851485403 GREGORY KEITH STINNETT RPH, DPH
Individual
Pharmacist1200 MEMORIAL DRIVE
DALTON, GA 30722
(706) 272-6430

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.