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Organization

INSTITUTE FOR CORRECTIVE SURGERY OF THE FOOT & ANKLE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID P MURPHY D.P.M. (MEDICAL DIRECTOR)
(912) 283-6471
Entity
Organization

Contact information

Practice address
2003 ALICE ST, WAYCROSS, GA 31501-6209
(912) 283-7596
(912) 283-1618
Mailing address
501 W ONEIDA ST, WAYCROSS, GA 31501-5337
(912) 283-7596
(912) 283-1618

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
148-201
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000894605A
GA
01
148-201
GA STATE PERMIT
GA
01
490004800
RAILROAD MEDICARE
GA
Enumeration date
06/18/2006
Last updated
08/20/2009
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