Provider Demographics
NPI:1932673233
Name:RAPHA FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:RAPHA FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL-SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-471-3125
Mailing Address - Street 1:PO BOX 4303
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31914-0303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3671 BUENA VISTA RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-4366
Practice Address - Country:US
Practice Address - Phone:706-984-0999
Practice Address - Fax:706-984-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-20
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty