Healthcare Provider Details
I. General information
NPI: 1952419178
Provider Name (Legal Business Name): COLUMBUS UROLOGY GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2006
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 HOSPITAL DR
COLUMBUS MS
39705-1920
US
IV. Provider business mailing address
321 HOSPITAL DR
COLUMBUS MS
39705-1920
US
V. Phone/Fax
- Phone: 662-327-2921
- Fax: 662-328-6858
- Phone: 662-327-2921
- Fax: 662-328-6858
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
L
HOWLAND
JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 662-327-2921