Healthcare Provider Details

I. General information

NPI: 1992852149
Provider Name (Legal Business Name): COLUMBIA ORTHOPAEDIC GROUP, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S KEENE ST
COLUMBIA MO
65201-7199
US

IV. Provider business mailing address

1 S KEENE ST
COLUMBIA MO
65201-7199
US

V. Phone/Fax

Practice location:
  • Phone: 573-443-2402
  • Fax: 573-443-0574
Mailing address:
  • Phone: 573-443-2402
  • Fax: 573-443-0574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0524940001
License Number StateMO

VIII. Authorized Official

Name: MR. ANDREW LOVEWELL
Title or Position: CEO
Credential: CEO
Phone: 573-443-2402