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General NPI Number Information
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NPI Number | 1437288255
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Entity Type | Organization
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Legal Business Name | RIVERTOWN RHEUMATOLOGY P.C.
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 700 CENTER ST STE 303
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City | COLUMBUS
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State | GA
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Zip | 31901-1546
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Country | US
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Telephone | 706-494-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 700 CENTER ST STE 303
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City | COLUMBUS
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State | GA
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Zip | 31902-1566
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Country | US
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Telephone | 706-494-8444
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Fax |
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Authorized Official
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Title or Position | RHEUMATOLOGIST/CEO
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Name | DR. PHILIP BRUCE MEADOW
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Credential | D.O.
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Telephone | 706-494-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 043709
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License Number State | GA
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