Organization
AUGUSTA FOOT & ANKLE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN NATHAN BENNETT DPM (PHYSICIAN)
(706) 312-3668
Entity
Organization
Contact information
Practice address
1416 WAINBROOK DR, AUGUSTA, GA 30909-6289
(706) 262-3668
(706) 262-3670
Mailing address
1416 WAINBROOK DR, AUGUSTA, GA 30909-6289
(706) 262-3668
(706) 262-3670
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332BC3200X
Customized Equipment (DME)
Primary
POD000842
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000812985B
—
GA
Enumeration date
11/13/2006
Last updated
07/03/2019
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