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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