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Organization
I BASILIO MD, PC
Active
Organization
I BASILIO MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEODERIS N BASILIO M.D. (PHYSICIAN)
(706) 507-5437
Entity
Organization
Contact information
Practice address
2039 WARM SPRINGS RD, COLUMBUS, GA 31904-7931
(706) 576-5570
Mailing address
104 14TH ST, COLUMBUS, GA 31901-2131
(706) 507-5437
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
NULL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
10/31/2011
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