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1110 Farr Rd Ste C Columbus GA 31907-8627 | |
| (706) 683-0909 | |
| (706) 683-9757 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1110 Farr Rd Ste C, Columbus, Georgia |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Maryland Way Ste 400 Brentwood TN 37027-7048 Ph: () - | 1110 Farr Rd Ste C Columbus GA 31907-8627 Ph: (706) 683-0909 |
| NPI Number | 1073090791 |
|---|---|
| Provider Enumeration Date | 07/25/2018 |
| Last Update Date | 08/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073090791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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