Provider Demographics
NPI:1578658910
Name:ENT ASSOCIATES OF COLUMBUS, P.C.
Entity Type:Organization
Organization Name:ENT ASSOCIATES OF COLUMBUS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEZCANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-324-7753
Mailing Address - Street 1:5900 RIVER RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:706-324-7753
Mailing Address - Fax:706-324-7756
Practice Address - Street 1:5900 RIVER RD
Practice Address - Street 2:SUITE 402
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-324-7753
Practice Address - Fax:706-324-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3739Medicare ID - Type Unspecified