Organization Name: | COMPREHENSIVE FOOT AND ANKLE CENTER,LLC |
NPI Number: | 1023285996 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DWIGHT MCLEISH (OWNER) |
Mailing Address: | 321 Margie Dr Warner Robins |
State: | GA US |
Postal Code: | 310887818 |
Phone Number: | 4783332362 |
Fax Number: | 4783332363 |
NPI Enumeration Date: | 05/10/2008 |
NPI Last Update Date: | 04/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 000722 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |