Organization
FOOT AND LEG CLINIC, PA
Active
Other names
AMBULATORY FOOT AND LEG SURGICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANA S. TAYLOR (CREDENTIALING MANAGER)
(770) 544-0444
Entity
Organization
Contact information
Practice address
1650 MULKEY RD, AUSTELL, GA 30106-1186
(770) 544-0444
(770) 874-8950
Mailing address
1652 MULKEY RD, AUSTELL, GA 30106
(770) 544-0444
(770) 874-8950
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042221A
—
GA
Enumeration date
03/21/2007
Last updated
08/13/2013
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