| Columbus Primary Care Internal Medicine Pc | |
|
1041 Talbotton Rd Columbus GA 31904-8745 | |
| (706) 660-8825 | |
| (706) 660-8897 |
| Full Name | Columbus Primary Care Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1041 Talbotton Rd, Columbus, Georgia |
| Authorized Official Name and Position | Edet O Bassey (CEO PRESIDENT) |
| Authorized Official Contact | 7066608825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Primary Care Internal Medicine Pc Po Box 2746 Columbus GA 31902-2746 Ph: (706) 660-8825 | Columbus Primary Care Internal Medicine Pc 1041 Talbotton Rd Columbus GA 31904-8745 Ph: (706) 660-8825 |
| NPI Number | 1063566909 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 05/11/2010 |
| Medicare PECOS PAC ID | 8022002757 |
|---|---|
| Medicare Enrollment ID | O20040414000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063566909 | NPI | - | NPPES |
| 000807881C | Medicaid | GA | |
| 00807881C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 044408 (Georgia) | Primary |
| Provider Name | Edet O Bassey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336123181 PECOS PAC ID: 4082712757 Enrollment ID: I20080304000072 |
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