Healthcare Provider Details

I. General information

NPI: 1891789921
Provider Name (Legal Business Name): JAMES H TAFF JR. PAA AAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2005
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 MANCHESTER EXPRESSWAY
COLUMBUS GA
31904
US

IV. Provider business mailing address

PO BOX 8417
COLUMBUS GA
31908
US

V. Phone/Fax

Practice location:
  • Phone: 800-232-5703
  • Fax: 334-279-1660
Mailing address:
  • Phone: 706-324-5482
  • Fax: 706-596-4293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number002452
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number002452
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: