| Columbus Physical Medicine Center, Inc. | |
|
118 Enterprise Ct Suite B Columbus GA 31904-9229 | |
| (706) 225-7008 | |
| Not Available |
| Full Name | Columbus Physical Medicine Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 118 Enterprise Ct, Columbus, Georgia |
| Authorized Official Name and Position | Eric N Codner (OWNER/PARTNER) |
| Authorized Official Contact | 7063301389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Physical Medicine Center, Inc. 118 Enterprise Ct Suite B Columbus GA 31904-9229 Ph: (706) 225-7008 | Columbus Physical Medicine Center, Inc. 118 Enterprise Ct Suite B Columbus GA 31904-9229 Ph: (706) 225-7008 |
| NPI Number | 1922346162 |
|---|---|
| Provider Enumeration Date | 01/23/2013 |
| Last Update Date | 10/19/2023 |
| Medicare PECOS PAC ID | 5799920799 |
|---|---|
| Medicare Enrollment ID | O20130322000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922346162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 029865 (Georgia) | Primary |
| Provider Name | Eric N Codner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1396766879 PECOS PAC ID: 8224055561 Enrollment ID: I20051028000840 |
| Provider Name | Anthony Ayokunle Olofintuyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144384827 PECOS PAC ID: 6709943566 Enrollment ID: I20090323000043 |
| Provider Name | Katherine Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548650617 PECOS PAC ID: 3971821273 Enrollment ID: I20150417000322 |
| Provider Name | Brandi Michelle Crowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346917838 PECOS PAC ID: 5799181772 Enrollment ID: I20210831002711 |
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