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General NPI Number Information
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NPI Number | 1700753035
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Entity Type | Organization
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Legal Business Name | KOOSH N DESAI MD PC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 2410 DOUBLE CHURCHES RD STE A
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City | COLUMBUS
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State | GA
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Zip | 31909-2987
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Country | US
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Telephone | 706-576-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 DOUBLE CHURCHES RD STE A
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City | COLUMBUS
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State | GA
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Zip | 31909-2987
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Country | US
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Telephone | 706-576-4600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KOOSH N DESAI
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Credential | MD
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Telephone | 706-576-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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