Organization
FOOT AND ANKLE CENTER OF AUGUSTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATANYA FYNE MD (PHYSICIAN)
(706) 739-0020
Entity
Organization
Contact information
Practice address
1142 DRUID PARK AVE, AUGUSTA, GA 30904-5850
(706) 739-0020
(706) 739-0024
Mailing address
1142 DRUID PARK AVE, AUGUSTA, GA 30904-5850
(706) 739-0020
(706) 739-0024
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000619
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
000619
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00428975B
—
GA
Enumeration date
04/18/2008
Last updated
04/18/2008
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