Organization
ACHILLES FOOT & ANKLE SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WILLIAM SHAFFER DPM (OWNER/PHYSICIAN)
(706) 769-9200
Entity
Organization
Contact information
Practice address
1580 MARS HILL RD, SUITE A, WATKINSVILLE, GA 30677-4836
(706) 769-9200
Mailing address
PO BOX 463, WATKINSVILLE, GA 30677-0012
(706) 769-9200
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000585
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP 2505
MEDICARE GROUP
GA
Enumeration date
08/29/2007
Last updated
03/19/2008
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