| Organization Name: | VALDOSTA PODIATRY ASSOCIATES, PC |
| NPI Number: | 1073556338 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMOTHY E PITTS (MEDICAL DIRECTOR/PHYSICIAN) |
| Mailing Address: | 2718 N Oak St Valdosta |
| State: | GA US |
| Postal Code: | 316021781 |
| Phone Number: | 2292423668 |
| Fax Number: | 2292538666 |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 10/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 092-146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |