MEDICARE: KMC FAMILY CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1306545975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMC FAMILY CARE PC

Provider Business Mailing Address
First Line	:	7500 VETERANS PKWY STE F
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-2525
Country	:	US
Telephone Number	:	706-221-2045
Fax Number	:	706-221-2059

Provider Business Practice Location Address
First Line	:	7500 VETERANS PKWY STE F
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-2525
Country	:	US
Telephone Number	:	601-562-7212
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUNIL KUMAR
Credential	:	MD
Telephone Number	:	601-562-7212

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	04/16/2023

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