Basic Information
| Provider Information | |||||||||
| NPI: | 1124493564 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST FRANCIS PHYSICIAN PRACTICES LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ST. FRANCIS PSYCHIATRISTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 16TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319011665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063203770 | ||||||||
| FaxNumber: | 7063203772 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 16TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319011665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063203770 | ||||||||
| FaxNumber: | 7063203772 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2015 | ||||||||
| LastUpdateDate: | 12/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | JUDY | ||||||||
| AuthorizedOfficialFirstName: | JESS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6159207000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.