| |
145 E Peacock St, Suite 4, Cochran, GA 31014-7846 | |
(478) 934-0776 | |
(478) 934-0779 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 145 E Peacock St, Cochran, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255680062 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Po Box 1297, Hawkinsville, GA 31036-7297 Ph: (478) 783-0200 | 145 E Peacock St, Suite 4, Cochran, GA 31014-7846 Ph: (478) 934-0776 |