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General NPI Number Information
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NPI Number | 1639619737
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Entity Type | Organization
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Legal Business Name | COLUMBUS FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 01/15/2018
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Provider Practice Location Address
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Address Line | 2827 WARM SPRINGS RD 3B
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City | COLUMBUS
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State | GA
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Zip | 31904-5246
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Country | US
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Telephone | 706-324-4177
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Fax | 706-322-9637
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Provider Business Mailing Address
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Address Line | 2827 WARM SPRINGS RD 3B
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City | COLUMBUS
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State | GA
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Zip | 31904-5246
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Country | US
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Telephone | 706-324-4177
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Fax | 706-322-9637
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | GLENN E FUSSELL
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Credential | MD
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Telephone | 706-324-4177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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