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Organization

FAMILY FOOT AND ANKLE CENTER

Active
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Organization

FAMILY FOOT AND ANKLE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROGER P THEODORE D.P.M. (PODIATRIST)
(478) 741-1192
Entity
Organization

Contact information

Practice address
841 MULBERRY ST, MACON, GA 31201-6756
(478) 741-1192
(478) 741-0029
Mailing address
841 MULBERRY ST, MACON, GA 31201-6756
(478) 741-1192
(478) 741-0029

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
POD000753
GA

Other

Enumeration date
01/11/2013
Last updated
02/04/2013
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