Organization
GEORGIA DOCTORS FOOT & LEG CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUPRIHATIN OSHIOKPEKHAI (OFFICE MANAGER)
(478) 328-6466
Entity
Organization
Contact information
Practice address
940 PIO NONO AVE, MACON, GA 31204-4059
(478) 254-4026
(478) 254-4031
Mailing address
1533 WATSON BLVD, WARNER ROBINS, GA 31093-3449
(478) 328-6466
(478) 328-1338
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000737492E
—
GA
Enumeration date
03/11/2022
Last updated
03/11/2022
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