Organization
GLOBAL WOUND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIVAKUMAR JAYABALAN PHD. (MBA) (OWNER / CEO)
(706) 284-5951
Entity
Organization
Contact information
Practice address
200 BOND ST, SUITE 109, ROYSTON, GA 30662-4137
(706) 245-4040
(706) 245-4070
Mailing address
629C RONALD REAGAN DR, EVANS, GA 30809-7607
(706) 868-0319
(706) 868-3719
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
028075
GA
213E00000X
Podiatrist
Primary
POD000686
GA
213E00000X
Podiatrist
POD000824
GA
213E00000X
Podiatrist
POD001075
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00521353B
—
GA
Enumeration date
02/07/2007
Last updated
09/06/2013
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