Organization
RIVERDALE FOOT, ANKLE AND LEG CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY LEE DICKERSON DPM (PRESIDENT/CEO)
(770) 997-3668
Entity
Organization
Contact information
Practice address
6567 PROFESSIONAL PL, RIVERDALE, GA 30274-2519
(770) 997-3668
(770) 997-3470
Mailing address
6567 PROFESSIONAL PL, RIVERDALE, GA 30274-2519
(770) 997-3668
(770) 997-3470
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000890
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00869679E
—
GA
01
—
52811908
BLUE CROSS BLUE SHIELD
GA
01
—
7302184
AETNA
GA
Enumeration date
12/15/2007
Last updated
01/08/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us