Healthcare Provider Details

I. General information

NPI: 1861586778
Provider Name (Legal Business Name): MARTIN ARMY COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 RIVER ROCK WAY
COLUMBUS GA
31907-1282
US

IV. Provider business mailing address

4025 RIVER ROCK WAY
COLUMBUS GA
31907-1282
US

V. Phone/Fax

Practice location:
  • Phone: 706-544-9196
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License NumberPT008541
License Number StateGA

VIII. Authorized Official

Name: DR. CHONG KO
Title or Position: STAFF PHYSICAL THERAPIST
Credential:
Phone: 706-544-9196