| Pediatrics & Family Practice Of Columbia, P.a. | |
|
2 W Lakeview Dr Suite 2 Columbia MS 39429-7960 | |
| (601) 444-4798 | |
| (601) 444-5127 |
| Full Name | Pediatrics & Family Practice Of Columbia, P.a. |
|---|---|
| Speciality | Pediatrics |
| Location | 2 W Lakeview Dr, Columbia, Mississippi |
| Authorized Official Name and Position | Jonathan Ryohwan Jang (PRESIDENT) |
| Authorized Official Contact | 6014444798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatrics & Family Practice Of Columbia, P.a. 2 W Lakeview Dr Suite 2 Columbia MS 39429-7960 Ph: (601) 444-4798 | Pediatrics & Family Practice Of Columbia, P.a. 2 W Lakeview Dr Suite 2 Columbia MS 39429-7960 Ph: (601) 444-4798 |
| NPI Number | 1730242462 |
|---|---|
| Provider Enumeration Date | 12/17/2006 |
| Last Update Date | 10/11/2011 |
| Medicare PECOS PAC ID | 7012181944 |
|---|---|
| Medicare Enrollment ID | O20111122000661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730242462 | NPI | - | NPPES |
| 08502504 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 17888 (Mississippi) | Secondary |
| 208000000X | Pediatrics | 17887 (Mississippi) | Primary |
| Provider Name | Jonathan Ryohwan Jang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073603171 PECOS PAC ID: 2668646597 Enrollment ID: I20111110000656 |
| Provider Name | Agnes Emerle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033273313 PECOS PAC ID: 4981878816 Enrollment ID: I20111110000729 |
Sharp Famity Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Eagle Day Ave, Columbia, MS 39429 Phone: 601-731-9108 Fax: 601-731-9190 | |
Children's International, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 930 Main St, Columbia, MS 39429 Phone: 985-646-1580 Fax: 888-863-4274 | |
Marion County Surgical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 910 Sumrall Rd, Columbia, MS 39429 Phone: 601-736-0177 Fax: 601-736-0179 | |
Marion County Surgical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 910 Sumrall Rd, Columbia, MS 39429 Phone: 601-736-0177 Fax: 601-736-0179 | |
Internal Medicine Clinic Of Columbia, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 914 Sumrall Rd, Columbia, MS 39429 Phone: 601-731-1470 Fax: 601-731-1474 | |
Columbia Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 502 Broad St, Columbia, MS 39429 Phone: 601-736-8282 Fax: 601-736-8333 | |
The Marion County Internal Medicine Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 912 Sumrall Rd, Columbia, MS 39429 Phone: 601-736-6443 Fax: 601-736-2543 |