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Individual

JILL KATHLEEN STEPNICKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
4385 JOHNS CREEK PKWY, SUITE 200, SUWANEE, GA 30024-6093
(770) 418-0456
(770) 418-1603
Mailing address
4385 JOHNS CREEK PKWY, SUITE 200, SUWANEE, GA 30024-6093
(770) 418-0456
(770) 418-1603

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000863
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000863
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000870471D
GA
01
260427
COVENTRY
GA
01
52825629
BCBS
01
7882185
AETNA
01
8694962
CIGNA
Enumeration date
08/02/2005
Last updated
04/04/2014
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