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General NPI Number Information
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NPI Number | 1528224524
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Entity Type | Organization
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Legal Business Name | COLUMBUS CENTER FOR REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, LLC
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 2323 WHITTLESEY RD
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City | COLUMBUS
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State | GA
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Zip | 31909-3011
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Country | US
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Telephone | 706-653-6344
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Fax | 706-653-8933
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Provider Business Mailing Address
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Address Line | 2323 WHITTLESEY RD
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City | COLUMBUS
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State | GA
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Zip | 31909-3011
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Country | US
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Telephone | 706-653-6344
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Fax | 706-653-8933
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DENICE MACE
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Credential |
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Telephone | 706-653-6344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 047371
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License Number State | GA
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