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Organization
HABERSHAM PODIATRY
Active
Organization
HABERSHAM PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANA M ROSE DPM (OWNER)
(706) 776-3132
Entity
Organization
Contact information
Practice address
134B MARKET CORNERS DR, CORNELIA, GA 30531-5766
(706) 776-3132
(706) 776-2836
Mailing address
PO BOX 191, CORNELIA, GA 30531-0191
(706) 776-3132
(706) 776-2836
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000902
GA
332B00000X
Durable Medical Equipment & Medical Supplies
4624980001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00871934C
—
GA
01
—
DN6573
RAILROAD MEDICARE
GA
Enumeration date
02/05/2008
Last updated
05/11/2011
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