VALDOSTA FOOT & ANKLE CLINIC P.C. NPI 1699975375

NPI Information

NPI: 1699975375
Provider Name: VALDOSTA FOOT & ANKLE CLINIC, P.C.
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

CLIA Number: 11D0976433

Address:
2800 N OAK ST
VALDOSTA, GA
ZIP 31602
Phone: (229) 244-1211
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VALDOSTA FOOT & ANKLE CLINIC, P.C. is a foot and ankle surgery podiatrist in Valdosta, GA. VALDOSTA FOOT & ANKLE CLINIC, P.C. NPI is 1699975375. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2800 N OAK ST
VALDOSTA, GA
ZIP 31602-716
Phone: (229) 244-1211
Fax: (229) 244-2721

The provider's authorized official is Michael R. Wallace .
The authorized official title is Owner and has the following contact phone number (229) 244-1211.

The CLIA number assigned to this NPI record is 11D0976433 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2007 and was last updated on 9/18/2013.

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			Yes

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

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