| |
1012 Ga Highway 247 S Ste 101, Kathleen, GA 31047-2349 | |
(478) 931-0776 | |
(478) 934-0779 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 1012 Ga Highway 247 S Ste 101, Kathleen, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568711380 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 1297, Hawkinsville, GA 31036-7297 Ph: (478) 783-0200 | 1012 Ga Highway 247 S Ste 101, Kathleen, GA 31047-2349 Ph: (478) 931-0776 |