Organization
INTERNAL MEDICINE CLINIC OF COLUMBIA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN F MCCRAW M.D. (PRESIDENT)
(601) 731-1470
Entity
Organization
Contact information
Practice address
914 SUMRALL RD, COLUMBIA, MS 39429-2652
(601) 731-1470
(601) 731-1474
Mailing address
914 SUMRALL RD, COLUMBIA, MS 39429-2652
(601) 731-1470
(601) 731-1474
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014377
—
MS
Enumeration date
07/25/2006
Last updated
02/18/2016
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