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Organization
WEST GEORGIA PODIATRY ASSOC.
Active
Organization
WEST GEORGIA PODIATRY ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY M HARRIS (PRACTICE ADMINISTRATOR)
(770) 832-3546
Entity
Organization
Contact information
Practice address
125 HISTORY DR, CARROLLTON, GA 30117-3969
(770) 832-3546
(770) 832-3518
Mailing address
125 HISTORY DR, CARROLLTON, GA 30117-3969
(770) 832-3546
(770) 832-3518
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
000434
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000478
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
000758
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000133834A
—
GA
05
—
000672306A
—
GA
Enumeration date
01/23/2007
Last updated
01/07/2008
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