Provider Demographics
NPI:1679696298
Name:COLUMBUS FAMILY MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:COLUMBUS FAMILY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-660-2894
Mailing Address - Street 1:2000 10TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3713
Mailing Address - Country:US
Mailing Address - Phone:706-660-2894
Mailing Address - Fax:706-660-2885
Practice Address - Street 1:2000 10TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3713
Practice Address - Country:US
Practice Address - Phone:706-660-2894
Practice Address - Fax:706-660-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty