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General NPI Number Information
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NPI Number | 1740287374
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Entity Type | Organization
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Legal Business Name | THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 670 LEIGH DR
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City | COLUMBUS
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State | MS
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Zip | 39705-3014
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Country | US
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Telephone | 662-328-1012
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Fax | 662-328-1507
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Provider Business Mailing Address
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Address Line | 670 LEIGH DR
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City | COLUMBUS
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State | MS
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Zip | 39705-3014
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Country | US
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Telephone | 662-328-1012
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Fax | 662-328-1507
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Authorized Official
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Title or Position | MANAGER
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Name | MISS GINA WALKER
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Credential |
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Telephone | 662-328-1012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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