Provider Demographics
NPI:1194995811
Name:COLUMBIA BARIATRIC ASSOCIATES
Entity type:Organization
Organization Name:COLUMBIA BARIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-777-1042
Mailing Address - Street 1:3220 BLUFF CREEK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-3525
Mailing Address - Country:US
Mailing Address - Phone:573-777-1042
Mailing Address - Fax:573-443-6843
Practice Address - Street 1:3220 BLUFF CREEK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-3525
Practice Address - Country:US
Practice Address - Phone:573-777-1042
Practice Address - Fax:573-443-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty