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General NPI Number Information
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NPI Number | 1609863133
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Entity Type | Organization
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Legal Business Name | COLUMBUS CLINIC, P.C.
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 610 19TH ST
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City | COLUMBUS
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State | GA
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Zip | 31901-1528
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Country | US
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Telephone | 706-322-7884
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Fax | 706-660-2118
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Provider Business Mailing Address
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Address Line | 610 19TH ST
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City | COLUMBUS
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State | GA
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Zip | 31901-1528
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Country | US
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Telephone | 706-322-7884
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Fax | 706-660-2118
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES S. ZACHARIAS
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Credential |
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Telephone | 706-660-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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