Organization
FOURROUX PROSTHETICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W KEITH WATSON CPO (OWNER / PRESIDENT)
(256) 534-8672
Entity
Organization
Contact information
Practice address
6630 MCGINNIS FERRY RD STE A, DULUTH, GA 30097-1563
(678) 584-1706
(800) 963-5010
Mailing address
2743 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4103
(256) 534-8672
(800) 963-5010
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003182704A
—
GA
01
—
35558878
BCBS OF GEORGIA
GA
Enumeration date
10/06/2014
Last updated
10/28/2020
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