Organization
COLUMBUS DIABETES & WOUND CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER STOUT (MANAGER)
(337) 315-7927
Entity
Organization
Contact information
Practice address
2300 MANCHESTER EXPY STE A005, COLUMBUS, GA 31904-6805
(337) 315-7927
Mailing address
2300 MANCHESTER EXPY STE A005, COLUMBUS, GA 31904-6805
(337) 315-7927
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/29/2025
Last updated
10/13/2025
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