Provider Demographics
NPI:1720135957
Name:COLUMBUS OCCUPATIONAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:COLUMBUS OCCUPATIONAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-241-5390
Mailing Address - Street 1:915 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702-5570
Mailing Address - Country:US
Mailing Address - Phone:662-241-5390
Mailing Address - Fax:662-241-5559
Practice Address - Street 1:915 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-5570
Practice Address - Country:US
Practice Address - Phone:662-241-5390
Practice Address - Fax:662-241-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMD4845174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSB02535Medicare UPIN