Individual
DR. CORLISS LA-SHUNUETTE AUSTIN-HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M., M.S.
Contact information
Practice address
770 VILLAGE SQUARE DR, STONE MOUNTAIN, GA 30083-3380
(404) 298-8998
(404) 298-7658
Mailing address
770 VILLAGE SQUARE DR, STONE MOUNTAIN, GA 30083-3380
(404) 298-8998
(404) 298-7658
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000536357B
—
GA
01
—
480023572
RAILROAD MEDICARE
—
Enumeration date
07/23/2006
Last updated
02/16/2012
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