| |
97 Hefner St, Ste 202, Ellijay, GA 30540 | |
(678) 880-0036 | |
(678) 493-7051 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 97 Hefner St, Ellijay, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073586715 | NPI | - | NPPES |
52866606003 | Other | GA | BCBS |
5168230003 | Other | GA | DMERC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | 000925 (Georgia) | Primary |
Mailing Address | Practice Location Address |
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236 Atlanta Road, Cumming, GA 30040 Ph: (770) 889-9596 | 97 Hefner St, Ste 202, Ellijay, GA 30540 Ph: (678) 880-0036 |