Organization
SUWANEE FOOT AND ANKLE SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOMMY LEE TALLY JR. DPM (PHYSICIAN)
(470) 589-1204
Entity
Organization
Contact information
Practice address
1300 PEACHTREE INDUSTRIAL BLVD STE 4105, SUWANEE, GA 30024-4541
(470) 589-1204
(470) 589-1465
Mailing address
1300 PEACHTREE INDUSTRIAL BLVD STE 4105, SUWANEE, GA 30024-4541
(470) 589-1204
(470) 589-1465
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003219790A
—
GA
Enumeration date
06/16/2021
Last updated
09/07/2021
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