| NPI | 1003950114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA S. TAYLOR Credentialing Manager 770-941-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2009-05-19 |