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General NPI Number Information
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NPI Number | 1902013709
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Entity Type | Organization
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Legal Business Name | WINSHIP CLINIC,P.C.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 2401 BROOKSTONE CENTRE PKWY BLDG. 200
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City | COLUMBUS
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State | GA
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Zip | 31904-4501
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Country | US
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Telephone | 706-256-0700
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Fax | 866-390-9155
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Provider Business Mailing Address
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Address Line | PO BOX 102748
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City | ATLANTA
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State | GA
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Zip | 30368-2748
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Country | US
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Telephone | 706-256-0700
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Fax | 866-390-9155
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. ELIZABETH M MARTIN
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Credential | M.D.
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Telephone | 706-256-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 040477
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License Number State | GA
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