Organization
OUTPATIENT CENTER FOR FOOT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J HENSON DPM (OWNER)
(770) 228-6644
Entity
Organization
Contact information
Practice address
730 S 8TH ST, GRIFFIN, GA 30224-4827
(770) 228-6644
(770) 228-5769
Mailing address
730 S 8TH ST, GRIFFIN, GA 30224-4827
(770) 228-6644
(770) 228-5769
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000621167B
—
GA
Enumeration date
01/26/2007
Last updated
02/18/2010
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