Organization
MCDUFFIE PODIATRY AND WOUND CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE S HAVRILLA DPM (OWNER)
(706) 595-8787
Entity
Organization
Contact information
Practice address
544 W HILL ST, THOMSON, GA 30824-2117
(706) 595-8787
(706) 595-8757
Mailing address
544 W HILL ST, THOMSON, GA 30824-2117
(706) 595-8787
(706) 595-8757
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
000848
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10041458
AMERIGROUP
GA
01
—
10581911
CIGNA
GA
01
—
322007
WELLCARE OF GEORGIA
GA
01
—
52773057-003
BLUE CROSS BLUE SHIELD GA
GA
01
—
5467067
AETNA
GA
05
—
618552906A
—
GA
01
—
GRP6239
MEDICARE GROUP #
GA
Enumeration date
10/05/2007
Last updated
02/06/2013
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