CHARLES JEFFREY SIDLOW D.P.M. NPI 1033179270

NPI Information

NPI: 1033179270
Provider Name: CHARLES JEFFREY SIDLOW, D.P.M.
Classification: Podiatrist - 213EP1101X
Entity Type: Individual

Specialization: Primary Podiatric Medicine

PECOS Registration: Yes

Address:
958 JOE FRANK HARRIS PKWY SE BLDG A
SUITE 106
CARTERSVILLE, GA
ZIP 30120
Phone: (770) 386-1389
Get Directions

Charles Jeffrey Sidlow, D.P.M. is a primary podiatric medicine podiatrist in Cartersville, GA. Charles Jeffrey Sidlow, D.P.M. NPI is 1033179270. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

958 JOE FRANK HARRIS PKWY SE BLDG A
SUITE 106
CARTERSVILLE, GA
ZIP 30120-175
Phone: (770) 386-1389
Fax: (770) 386-4894

The NPI 1033179270 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 3/23/2006 and was last updated on 12/19/2012.

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	213EP1101X	Podiatrist	Primary Podiatric Medicine	POD000560	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
1	U19472	MEDICARE UPIN	GEORGIA
2	000333803A	MEDICAID	GEORGIA
3	1588842686	MEDICARE NSC	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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