S.DEKALB FOOT & ANKLE SURGICAL CTR NPI 1265638381

NPI Information

NPI: 1265638381
Provider Name: S.DEKALB FOOT & ANKLE SURGICAL CTR

Doing Business As: FAMILY FOOT & ANKLE CTR

Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
841 MULBERRY ST
MACON, GA
ZIP 31201
Phone: (478) 741-1192
Get Directions

S.DEKALB FOOT & ANKLE SURGICAL CTR is a podiatric clinic center in Macon, GA. S.DEKALB FOOT & ANKLE SURGICAL CTR NPI is 1265638381. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Foot & Ankle Ctr.

The provider's business location address is:

841 MULBERRY ST
MACON, GA
ZIP 31201-756
Phone: (478) 741-1192
Fax: (478) 741-0029

The provider's authorized official is Roger Peter Theodore .
The authorized official title is Podiatrist and has the following contact phone number (404) 241-7848.

The enumeration date for this NPI number is 6/25/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP1100X	Clinic/Center	Podiatric	000753	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00655322A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »