Healthcare Provider Details

I. General information

NPI: 1164881132
Provider Name (Legal Business Name): T J HEALTH COLUMBIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 WELLNESS WAY
COLUMBIA KY
42728-1123
US

IV. Provider business mailing address

PO BOX 645996
CINCINNATI OH
45264-5996
US

V. Phone/Fax

Practice location:
  • Phone: 270-384-4753
  • Fax: 270-384-6228
Mailing address:
  • Phone: 270-651-4444
  • Fax: 270-651-4892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NEIL THORNBURY
Title or Position: CEO
Credential:
Phone: 270-651-4444