| John J Land Iv Pc | |
|
1107 Broadrick Dr, Dalton, GA 30720-2592 | |
| (706) 278-5558 | |
| (706) 278-6334 |
| Full Name | John J Land Iv Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 1107 Broadrick Dr, Dalton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356500573 | NPI | - | NPPES |
| 480027427 | Other | GA | RAIL ROAD MEDICARE |
| 1440694 | Other | GA | UMWA |
| 000828385A | Medicaid | GA | |
| 3351905 | Other | TN | MEDICARE |
| 3124909 | Other | TN | BLUE CROSS/ BLUE SHIELD |
| 52432145 | Other | GA | BLUE CROSS/ BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | POD000679 (Georgia) | Primary |
| Provider Name | John J Land |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568548220 PECOS PAC ID: 2860496908 Enrollment ID: I20080603000642 |
| Provider Name | Greg Lifferth |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124552492 PECOS PAC ID: 9133544125 Enrollment ID: I20200807001826 |
| Mailing Address | Practice Location Address |
|---|---|
| John J Land Iv Pc 1107 Broadrick Dr, Dalton, GA 30720-2592 Ph: (706) 278-5558 | John J Land Iv Pc 1107 Broadrick Dr, Dalton, GA 30720-2592 Ph: (706) 278-5558 |
Dr. Shelley Brand, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1505 Professional Ct, Dalton, GA 30720 Phone: 706-259-6882 Fax: 706-259-3786 | |
Dr. Spencer Carlton Misner, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1432 Broadrick Drive, Dalton Foot And Ankle Surgery Center, Dalton, GA 30720 Phone: 706-226-1130 Fax: 706-272-7043 | |
Village Podiatry Centers Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1505 Professional Ct, Dalton, GA 30720 Phone: 706-259-6882 Fax: 706-259-3786 | |
Dr. Roger Allen Hunt Jr., DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1505 Professional Ct, Dalton, GA 30720 Phone: 706-259-6882 Fax: 706-259-3786 | |
Dr. Trey Morgan Edwards, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1505 Professional Ct, Dalton, GA 30720 Phone: 706-259-6882 Fax: 706-259-3786 | |
Village Podiatry Centers Podiatrist Medicare: Medicare Enrolled Practice Location: 1505 Professional Ct, Dalton, GA 30720 Phone: 706-259-6882 Fax: 706-259-3786 | |
Jalpa R Patel, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1716 Cleveland Hwy, Suite 104, Dalton, GA 30721 Phone: 706-259-6882 |