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General NPI Number Information
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NPI Number | 1326412420
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Entity Type | Organization
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Legal Business Name | COLUMBUS SURGICAL SPECIALISTS, LLC
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 1900 10TH AVE STE 201
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City | COLUMBUS
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State | GA
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Zip | 31901-3602
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Country | US
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Telephone | 706-984-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 10TH AVE STE 201
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City | COLUMBUS
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State | GA
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Zip | 31901-3602
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Country | US
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Telephone | 706-984-7400
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Fax | 706-984-7401
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM TAYLOR
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Credential | MD
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Telephone | 706-984-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 063806
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License Number State | GA
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