| Brookstone Internal Medicine | |
|
400 Brookstone Centre Pkwy Suite 200 Columbus GA 31904-3639 | |
| (706) 507-3332 | |
| (706) 507-3359 |
| Full Name | Brookstone Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 Brookstone Centre Pkwy, Columbus, Georgia |
| Authorized Official Name and Position | Samantha Lyn Boroughs (CEO) |
| Authorized Official Contact | 7069877509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookstone Internal Medicine Po Box 184 Fortson GA 31808-0184 Ph: (706) 507-3332 | Brookstone Internal Medicine 400 Brookstone Centre Pkwy Suite 200 Columbus GA 31904-3639 Ph: (706) 507-3332 |
| NPI Number | 1396055091 |
|---|---|
| Provider Enumeration Date | 10/14/2010 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 3476742354 |
|---|---|
| Medicare Enrollment ID | O20110107000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396055091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 54794 (Georgia) | Primary |
| Provider Name | Samantha L Boroughs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659385979 PECOS PAC ID: 1052375797 Enrollment ID: I20041112001014 |
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