| |
3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | |
(678) 561-9000 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376191106 | NPI | - | NPPES |
1043662364 | Other | NPI | |
1194107425 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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1975 Highway 54 W Ste 205, Peachtree City, GA 30269-4794 Ph: (678) 561-9000 | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 Ph: (678) 561-9000 |