# COLUMBIANA CLINIC LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356492904
- **Authorized official:** ANTHONY CIULLA (ADMINISTRATOR)
- **Authorized official phone:** (205) 669-3138

## Contact information

- **Practice address:** 22266 HIGHWAY 25, COLUMBIANA, AL 35051-8618
- **Practice address phone:** (205) 669-3138
- **Practice address fax:** (205) 669-8718
- **Mailing address:** 22266 HIGHWAY 25, COLUMBIANA, AL 35051-8618
- **Mailing address phone:** (205) 669-3138
- **Mailing address fax:** (205) 669-8718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 11/14/2019