Feoderis N Basilio
Adolescent Medicine
104 14th St
Columbus
, Georgia 31901-2131
Feoderis N Basilio
Adolescent Medicine
104 14th St
Columbus
, Georgia 31901-2131
(706) 507-5499
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Feoderis N Basilio
- 104 14th St
- Columbus, GA
- Zip : 31901-2131
- Fax : (706) 507-5499
- Phone : (706) 507-5437
Second Address
- Feoderis N Basilio
- 104 14th St
- Columbus, GA
- Zip : 31901-2131
- Fax : (706) 507-5499
- Phone : (706) 507-5437
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Is Feoderis N Basilio a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 050092 | GA |
National Provider Identifier
| NPI | 1023143393 |
|---|---|
| Provider Name | Feoderis N Basilio |
| First Address | Columbus, GA 31901-2131 |
| Second Address | Columbus, GA 31901-2131 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/02/2007 |
| Last Update Date | 30/06/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000958702A | (05) | GA |
| 000958702A | PEACH STATE HEALTH PLAN (01) | GA |
| 306085 | WELLCARE (01) | GA |
| 52009279 | BCBS GA (01) | GA |
| 60103339 | BCBS AL (01) | AL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.