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Organization

A. LOUIS JIMENEZ, DPM, PC

Active
Other names
Primera Foot & Ankle Centers
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DORIAN JIMENEZ DPM (CEO)
(770) 979-0900
Entity
Organization

Contact information

Practice address
2220 WISTERIA DR, SUITE 202, SNELLVILLE, GA 30078-4604
(770) 979-0900
(770) 979-2852
Mailing address
PO BOX 527, SNELLVILLE, GA 30078-0527
(770) 979-0900
(770) 979-2852

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000440
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000157957A
GA
01
CM4891
RAILROAD MEDICARE
GA
Enumeration date
07/06/2007
Last updated
10/19/2015
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