Organization
FAMILY PODIATRY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W CUSHNER DPM (CEO)
(912) 489-8727
Entity
Organization
Contact information
Practice address
1804 SEMINOLE DRIVE, VIDALIA, GA 30474
(912) 537-9864
(912) 537-2914
Mailing address
PO BOX 1106, STATESBORO, GA 30459-1106
(912) 489-8727
(912) 764-7882
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
2007000326
GA
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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