Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Our Lady of the Roses Primary Care

Organization General Practice Physician · NPI 1801119375

Our Lady of the Roses Primary Care is a General Practice Physician in Columbus, Georgia. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
2

Practice location Address checks out

808 21st St
Columbus, GA 31904-8817
Phone: (706) 221-7232
Fax: (706) 221-7246
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1801119375
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gerald Wieczorek — Registering Agent · (706) 327-4880
NPI enumeratedMarch 11, 2010
Last updated in NPPESFebruary 25, 2014
Mailing addressPo Box 1957, Fortson, GA 31808-1957

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