FOOT AND LEG CLINIC PC NPI 1003950114

NPI Information

NPI: 1003950114
Provider Name: FOOT AND LEG CLINIC, PC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1650 MULKEY RD
AUSTELL, GA
ZIP 30106
Phone: (770) 941-3633
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FOOT AND LEG CLINIC, PC is a foot and ankle surgery podiatrist in Austell, GA. FOOT AND LEG CLINIC, PC NPI is 1003950114. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1650 MULKEY RD
AUSTELL, GA
ZIP 30106-186
Phone: (770) 941-3633
Fax: (770) 944-9038

The provider's authorized official is Jana S. Taylor .
The authorized official title is Credentialing Manager and has the following contact phone number (770) 941-3633.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 5/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery		GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0628010001	MEDICARE NSC
2	GRP1229	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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