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Organization
ALLIED ANKLE & FOOTCARE CENTERS PC
Active
Organization
ALLIED ANKLE & FOOTCARE CENTERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LOUIS BOUCHARD DPM (MEDICAL DIRECTOR)
(770) 255-0425
Entity
Organization
Contact information
Practice address
4045A LINDLEY CIR, POWDER SPRINGS, GA 30127-2711
(770) 943-2121
(770) 943-3919
Mailing address
PO BOX 491658, LAWRENCEVILLE, GA 30049-0028
(770) 255-0424
(770) 255-0425
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000418
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP446
MEDICARE GROUP
GA
Enumeration date
04/29/2008
Last updated
06/16/2008
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