Organization
COLUMBUS PULMONARY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLI AVERY (OFFICE MANAGER)
(662) 327-3195
Entity
Organization
Contact information
Practice address
255 BAPTIST BLVD, STE 302, COLUMBUS, MS 39705-2011
(662) 327-3195
(662) 243-1070
Mailing address
PO BOX 8401, COLUMBUS, MS 39705-0010
(662) 327-3195
(662) 243-1070
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
13124
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123535
—
MS
Enumeration date
03/11/2008
Last updated
07/20/2012
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