Provider Demographics
NPI:1487658381
Name:PHYSICIANS PRACTICE ORGANIZATION, INC
Entity Type:Organization
Organization Name:PHYSICIANS PRACTICE ORGANIZATION, INC
Other - Org Name:COLUMBUS INTERNAL MEDICINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALESSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-988-2223
Mailing Address - Street 1:4050 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203
Mailing Address - Country:US
Mailing Address - Phone:812-376-9427
Mailing Address - Fax:
Practice Address - Street 1:4050 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203
Practice Address - Country:US
Practice Address - Phone:812-376-9427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200878810AMedicaid
IN200878810AMedicaid