Provider Demographics
NPI:1851534739
Name:COLUMBUS FAMILY PHYSICIANS
Entity Type:Organization
Organization Name:COLUMBUS FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-237-0904
Mailing Address - Street 1:3900 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-2301
Mailing Address - Country:US
Mailing Address - Phone:614-237-0904
Mailing Address - Fax:614-237-2401
Practice Address - Street 1:3900 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2301
Practice Address - Country:US
Practice Address - Phone:614-237-0904
Practice Address - Fax:614-237-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1912935453OtherWILLIAM J MORRIS, M.D., NPI INDIVIDUAL NUMBER
OH1801978796OtherKATHLEEN J SKUBAK, C.N.P. NPI INDIVIDUAL NUMBER
OH1881700342OtherEDWARD J LANE, M.D. NPI INDIVIDUAL NUMBER