Organization
NORTH GA PODIATRIC MEDICINE AND SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J SIDLOW DPM (PODIATRIST)
(770) 386-1389
Entity
Organization
Contact information
Practice address
958A JOE FRANK HARRIS PKWY SE STE 106, CARTERSVILLE, GA 30120-2129
(770) 386-1389
(770) 386-4894
Mailing address
958A JOE FRANK HARRIS PKWY SE STE 106, CARTERSVILLE, GA 30120-2129
(770) 386-1389
(770) 386-4894
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0508570001
GA
Other
Enumeration date
01/31/2008
Last updated
12/18/2012
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