| Columbia Family Clinic | |
|
502 Broad St Columbia MS 39429-3037 | |
| (601) 736-8282 | |
| (601) 736-8333 |
| Full Name | Columbia Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 502 Broad St, Columbia, Mississippi |
| Authorized Official Name and Position | Bryan N Batson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6012646000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Family Clinic 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 579-5463 | Columbia Family Clinic 502 Broad St Columbia MS 39429-3037 Ph: (601) 736-8282 |
| NPI Number | 1295835544 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 02/18/2021 |
| Medicare PECOS PAC ID | 5193706794 |
|---|---|
| Medicare Enrollment ID | O20100930062414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295835544 | NPI | - | NPPES |
| 09013842 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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