Healthcare Provider Details

I. General information

NPI: 1700217536
Provider Name (Legal Business Name): THE RELIEF INSTITUTE OF COLUMBUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7661 KAYNE BLVD BLDGA
COLUMBUS GA
31909-2545
US

IV. Provider business mailing address

18520 NW 67TH AVE 278
HIALEAH FL
33015-3302
US

V. Phone/Fax

Practice location:
  • Phone: 706-576-2333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number115737
License Number StateGA

VIII. Authorized Official

Name: JUNIOR BIGGS
Title or Position: MGR
Credential:
Phone: 305-849-3890