Provider Demographics
NPI:1578719563
Name:COLUMBUS BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:COLUMBUS BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:KHALID
Authorized Official - Last Name:SOOMRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-494-1460
Mailing Address - Street 1:3001 HAMILTON ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:706-494-1460
Mailing Address - Fax:706-494-1461
Practice Address - Street 1:3001 HAMILTON ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-494-1460
Practice Address - Fax:706-494-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty