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NPI Code Detail

MEDICARE: COLUMBUS URGENT CARE CENTER

MEDICARE: COLUMBUS URGENT CARE CENTER
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
12083X0100XOccupational Medicine Physician
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548338635
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBUS URGENT CARE CENTER
Provider Business Mailing Address
First Line : 2502 25TH ST
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-3728
Country : US
Telephone Number : 812-372-8883
Fax Number : 812-372-8964
Provider Business Practice Location Address
First Line : 2502 25TH ST
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-3728
Country : US
Telephone Number : 812-372-8883
Fax Number : 812-372-8964
Authorized Official
Title or Position : BOARD OF DIRECTORS
Name : MR. KURT ELLIS
Credential :
Telephone Number : 812-376-5015
Provider Enumeration Date : 11/30/2006
Last Update Date : 01/18/2013

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1033287149 — RICHARD MIETHKE MD
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1851469977 — SHERRY LITTLE NP
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Directions to “COLUMBUS URGENT CARE CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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