Organization
COLUMBUS CARDIOLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN JOHNSON (PRACTICE ADMINISTRATOR)
(706) 323-5552
Entity
Organization
Contact information
Practice address
2300 MANCHESTER EXPY STE 2001, COLUMBUS, GA 31904-6877
(706) 323-5552
(706) 324-5695
Mailing address
2300 MANCHESTER EXPY STE 2001, COLUMBUS, GA 31904-6877
(706) 323-5552
(706) 324-5695
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028277A
—
GA
05
—
529403690
—
AL
01
—
CL6888
RAILROAD MEDICARE
GA
Enumeration date
09/27/2006
Last updated
12/10/2024
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