| Organization Name: | SATILLA FOOT & ANKLE, LLC |
| NPI Number: | 1063777340 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLIE B DOWLING (MANAGER) |
| Mailing Address: | 2005 Pioneer St Ste A Waycross |
| State: | GA US |
| Postal Code: | 315016205 |
| Phone Number: | 9124903668 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2012 |
| NPI Last Update Date: | 07/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | POD001151 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |