Individual
DR. TOMMY LEE TALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1300 PEACHTREE INDUSTRIAL BLVD STE 4105, SUWANEE, GA 30024-4541
(470) 589-1204
(470) 589-1465
Mailing address
1300 PEACHTREE INDUSTRIAL BLVD STE 4105, SUWANEE, GA 30024-4541
(470) 589-1204
(470) 598-1465
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001388
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003219790A
—
GA
Enumeration date
10/10/2018
Last updated
09/07/2021
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