Individual
DR. DOUGLAS H ELLEBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3825 MEDICAL PARK DR., STE. 200, AUSTELL, GA 30106-6831
(770) 745-5101
(770) 745-9740
Mailing address
900 CIRCLE 75 PKWY., STE. 900, ATLANTA, GA 30339-3084
(770) 384-0284
(404) 446-1957
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000433
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
000433
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000138993A
—
GA
05
—
1756385
—
LA
Enumeration date
10/24/2005
Last updated
08/12/2015
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