Individual
STEVEN BLAKELY GEORGIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
872 WINTER ST, LUCEDALE, MS 39452-5797
(601) 673-4625
(601) 673-4627
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 673-4625
(601) 673-4627
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
80244
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/02/2019
Last updated
07/15/2022
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