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233 12th St Suite 800 Columbus GA 31901-2462 | |
| (877) 800-4882 | |
| (407) 786-4011 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 233 12th St, Columbus, Georgia |
| Authorized Official Name and Position | Mary Consolato (PRACTICE MANAGER) |
| Authorized Official Contact | 8778004882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 6250 Charlottesville VA 22906-6250 Ph: (877) 800-4882 | 233 12th St Suite 800 Columbus GA 31901-2462 Ph: (877) 800-4882 |
| NPI Number | 1417146408 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417146408 | NPI | - | NPPES |
| DF4461 | Other | RR MEDICARE |
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