Provider Demographics
NPI:1568344331
Name:COLUMBUS FAMILY MEDICAL CLINIC, LLC
Entity type:Organization
Organization Name:COLUMBUS FAMILY MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:662-251-0342
Mailing Address - Street 1:358 SAGAMORE CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1147
Mailing Address - Country:US
Mailing Address - Phone:662-251-0342
Mailing Address - Fax:
Practice Address - Street 1:358 SAGAMORE CIR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1147
Practice Address - Country:US
Practice Address - Phone:662-251-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty