Provider Demographics
NPI:1316004021
Name:COLUMBUS EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:COLUMBUS EYE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:706-322-5528
Mailing Address - Street 1:109 12TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-5245
Mailing Address - Country:US
Mailing Address - Phone:706-322-5528
Mailing Address - Fax:706-322-6559
Practice Address - Street 1:109 12TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-5245
Practice Address - Country:US
Practice Address - Phone:706-322-5528
Practice Address - Fax:706-322-6559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1821332H00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA410006834OtherRAILROAD MEDICARE
GA=========OtherTAX ID
GAU30660Medicare UPIN
GA=========OtherTAX ID
GA410006834OtherRAILROAD MEDICARE
GA0430710001Medicare NSC