Provider Demographics
NPI:1952425159
Name:FAMILY PHYSICIANS OF COLUMBUS
Entity type:Organization
Organization Name:FAMILY PHYSICIANS OF COLUMBUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:BONNER
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-494-0694
Mailing Address - Street 1:6801 RIVER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3352
Mailing Address - Country:US
Mailing Address - Phone:706-494-0694
Mailing Address - Fax:
Practice Address - Street 1:6801 RIVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3352
Practice Address - Country:US
Practice Address - Phone:706-494-0694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA050525OtherBLUE CROOS SEXTON
GA1285767566OtherNURSE PRACTITIONER
GA1962476788OtherNURSE PRACTITIONER NPI
GA1982678702OtherSEXTON NPI
GA785320OtherBLUE CROSS
GA00655168DMedicaid
GA1962476788OtherNURSE PRACTITIONER
GA00480939GMedicaid
GA080190595OtherRR CARE SEXTON
GA080190596OtherRR CARE LEWIS
GA1366416166OtherLEWIS NPI
GA080190595OtherRR CARE SEXTON
GA1962476788OtherNURSE PRACTITIONER NPI
GA1285767566OtherNURSE PRACTITIONER
GA00655168DMedicaid