1952425159 NPI number — FAMILY PHYSICIANS OF COLUMBUS

Table of content: (NPI 1952425159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952425159 NPI number — FAMILY PHYSICIANS OF COLUMBUS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY PHYSICIANS OF COLUMBUS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952425159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6801 RIVER RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31904-3352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-494-0694
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6801 RIVER RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31904-3352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-494-0694
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEWIS
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
BONNER
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
706-494-0694

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 050525 . This is a "BLUE CROOS SEXTON" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1285767566 . This is a "NURSE PRACTITIONER" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1962476788 . This is a "NURSE PRACTITIONER NPI" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1982678702 . This is a "SEXTON NPI" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 785320 . This is a "BLUE CROSS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 00655168D , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1962476788 . This is a "NURSE PRACTITIONER" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 00480939G , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080190595 . This is a "RR CARE SEXTON" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 080190596 . This is a "RR CARE LEWIS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1366416166 . This is a "LEWIS NPI" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".