Organization
COLUMBUS ORTHOPEDIC OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA WALKER (MANAGER)
(662) 328-1012
Entity
Organization
Contact information
Practice address
640 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-7123
(662) 328-7156
Mailing address
640 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-7123
(662) 328-7156
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
25C0001046
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07482223
—
MS
Enumeration date
07/22/2006
Last updated
06/22/2020
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