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General NPI Number Information
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NPI Number | 1902073844
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Entity Type | Organization
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Legal Business Name | THE MEDICAL CENTER HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 100 FRIST CT
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City | COLUMBUS
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State | GA
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Zip | 31909-3578
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Country | US
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Telephone | 706-494-2100
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Fax | 706-494-2446
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Provider Business Mailing Address
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Address Line | 707 CENTER ST SUITE 400
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City | COLUMBUS
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State | GA
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Zip | 31901-1575
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Country | US
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Telephone | 706-660-6103
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Fax | 706-660-6520
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Authorized Official
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Title or Position | CHAIRMAN OF BOARD OF DIRECTORS
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Name | DAVID B MCMICKEN
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Credential | M.D.
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Telephone | 706-660-6103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 106-645
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License Number State | GA
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