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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) 255-0420
Entity
Organization
Contact information
Practice address
15 HURRICANE SHOALS RD NE, SUITE B, LAWRENCEVILLE, GA 30046-4454
(770) 277-7373
(770) 277-1755
Mailing address
PO BOX 491658, LAWRENCEVILLE, GA 30049-0028
(770) 255-0420
(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
04/30/2012
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