Organization
PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN RYOHWAN JANG MD (PRESIDENT)
(601) 444-4798
Entity
Organization
Contact information
Practice address
2 W LAKEVIEW DR, SUITE 2, COLUMBIA, MS 39429-7960
(601) 444-4798
(601) 444-5127
Mailing address
2 W LAKEVIEW DR, SUITE 2, COLUMBIA, MS 39429-7960
(601) 444-4798
(601) 444-5127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
17888
MS
208000000X
Pediatrics Physician
Primary
17887
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08502504
—
MS
Enumeration date
12/17/2006
Last updated
10/11/2011
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