THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.

Provider Demographics

• NPI: 1740287374
• Name: THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.
• Entity type: Organization
• Organization Name: THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.
• Authorized Official - Title/Position: MANAGER
• Authorized Official - Prefix: MISS
• Authorized Official - First Name: GINA
• Authorized Official - Last Name: WALKER
• Authorized Official - Phone: 662-328-1012
• Mailing Address - Street 1: 670 LEIGH DR
• Mailing Address - City: COLUMBUS
• Mailing Address - State: MS
• Mailing Address - Zip Code: 39705-3014
• Mailing Address - Country: US
• Mailing Address - Phone: 662-328-1012
• Mailing Address - Fax: 662-328-1507
• Practice Address - Street 1: 670 LEIGH DR
• Practice Address - City: COLUMBUS
• Practice Address - State: MS
• Practice Address - Zip Code: 39705-3014
• Practice Address - Country: US
• Practice Address - Phone: 662-328-1012
• Practice Address - Fax: 662-328-1507
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-06-28
• Last Update Date: 2022-10-24

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MS	0114974	Medicaid
MS	03500355	Medicaid
MS	05357253	Medicaid
MS	09259057	Medicaid
MS	09011584	Medicaid
MS	00776741	Medicaid
MS	03886364	Medicaid
MS	00776741	Medicaid
MS	09259057	Medicaid
MS	08681064	Medicaid
MS	08577555	Medicaid
MS	00080755	Medicaid
MS	00701279	Medicaid
MS	0114974	Medicaid
MS	05301759	Medicaid
MS	0024027	Medicaid
MS	03203715	Medicaid
MS	05357253	Medicaid
MS	08876761	Medicaid
MS	03479811	Medicaid
MS	03500355	Medicaid
MS	03886364	Medicaid
MS	271461YM43	Medicare UPIN
MS	00701279	Medicaid
MS	09259057	Medicaid
MS	05301759	Medicaid
MS	200000211	Medicare UPIN
MS	G00215	Medicare UPIN
MS	302I209082	Medicare UPIN
MS	05357253	Medicaid
MS	200000149	Medicare PIN
MS	525299YM43	Medicare UPIN
MS	446139YM43	Medicare UPIN
MS	415761YM43	Medicare UPIN
MS	302I205282	Medicare UPIN
MS	08876761	Medicaid
MS	03500355	Medicaid
MS	01851204	Medicaid
MS	08577555	Medicaid
MS	03886364	Medicaid
MS	330943YM43	Medicare UPIN
MS	328305YM43	Medicare UPIN
MS	320990YM43	Medicare UPIN
MS	03203715	Medicaid
MS	01429835	Medicaid
MS	0114974	Medicaid
MS	0541610001	Medicare NSC
MS	200000414	Medicare PIN