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2737 Warm Springs Rd Suite B & C Columbus GA 31904-6859 | |
| (706) 653-2255 | |
| (706) 653-2329 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 2737 Warm Springs Rd, Columbus, Georgia |
| Authorized Official Name and Position | Charles P. Roman (CEO) |
| Authorized Official Contact | 7066532255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4519 Woodruff Rd Suite 4 Columbus GA 31904-6011 Ph: (706) 653-2255 | 2737 Warm Springs Rd Suite B & C Columbus GA 31904-6859 Ph: (706) 653-2255 |
| NPI Number | 1396853388 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 09/26/2012 |
| Medicare PECOS PAC ID | 7113914599 |
|---|---|
| Medicare Enrollment ID | O20040428000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396853388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Timothy K Hocking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306850078 PECOS PAC ID: 2860399318 Enrollment ID: I20060821000126 |
| Provider Name | Trina C Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316191950 PECOS PAC ID: 8123144219 Enrollment ID: I20101204000016 |
| Provider Name | Gloria Y Browne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831189984 PECOS PAC ID: 6507935111 Enrollment ID: I20110520000715 |
| Provider Name | Charles Paul Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487636577 PECOS PAC ID: 6800826116 Enrollment ID: I20111013000353 |
| Provider Name | Edna E Mallory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255682381 PECOS PAC ID: 1456595081 Enrollment ID: I20130920000101 |
| Provider Name | Tiffany James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154716660 PECOS PAC ID: 2961722616 Enrollment ID: I20150520000230 |
| Provider Name | Ki-hyun Cho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992061154 PECOS PAC ID: 6406176650 Enrollment ID: I20150529000650 |
| Provider Name | Tarulata Bhaidasna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275593667 PECOS PAC ID: 9739107129 Enrollment ID: I20151013000900 |
| Provider Name | Clara C Orji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568663870 PECOS PAC ID: 1658463195 Enrollment ID: I20151113002575 |
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