MCDUFFIE PODIATRY AND WOUND CARE PC NPI 1760670673

NPI Information

NPI: 1760670673
Provider Name: MCDUFFIE PODIATRY AND WOUND CARE, PC
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
544 W HILL ST
THOMSON, GA
ZIP 30824
Phone: (706) 595-8787
Get Directions

MCDUFFIE PODIATRY AND WOUND CARE, PC is a primary podiatric medicine podiatrist in Thomson, GA. MCDUFFIE PODIATRY AND WOUND CARE, PC NPI is 1760670673. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

544 W HILL ST
THOMSON, GA
ZIP 30824-117
Phone: (706) 595-8787
Fax: (706) 595-8757

The provider's authorized official is George S Havrilla .
The authorized official title is Owner and has the following contact phone number (706) 595-8787.

The enumeration date for this NPI number is 10/5/2007 and was last updated on 2/6/2013.

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	213EP1101X	Podiatrist	Primary Podiatric Medicine	000848	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	10041458	OTHER	GEORGIA	AMERIGROUP
2	618552906A	MEDICAID	GEORGIA
3	5467067	OTHER	GEORGIA	AETNA
4	10581911	OTHER	GEORGIA	CIGNA
5	GRP6239	OTHER	GEORGIA	MEDICARE GROUP #
6	U48308	MEDICARE UPIN	GEORGIA
7	5040540001	MEDICARE NSC	GEORGIA
8	P00036176	MEDICARE PIN	GEORGIA
9	48SCCNB	MEDICARE PIN	GEORGIA
10	322007	OTHER	GEORGIA	WELLCARE OF GEORGIA
11	52773057-003	OTHER	GEORGIA	BLUE CROSS BLUE SHIELD GA

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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