Provider Demographics
NPI:1235123274
Name:ADVANCED HOSPITALISTS GROUP PA
Entity type:Organization
Organization Name:ADVANCED HOSPITALISTS GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-418-1222
Mailing Address - Street 1:15260 NW 147TH DR
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-5309
Mailing Address - Country:US
Mailing Address - Phone:386-418-1222
Mailing Address - Fax:386-418-0622
Practice Address - Street 1:STATE ROAD 26 AT I75
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32614
Practice Address - Country:US
Practice Address - Phone:352-333-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6205Medicare ID - Type Unspecified