Doctor Name: | MARGO ANGELA JIMENEZ |
NPI Number: | 1083670673 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | POD001017 |
Business Practice Address: | 2175 North Rd Snellville, GA - 300782630 |
Business Phone Number: | 7709790900 |
Business Fax Number: | |
Mailing Address: | Po Box 527, SNELLVILLE |
State: | GA |
Postal Code: | 300780527 |
Phone Number: | 7709790900 |
Fax Number: | |
NPI Enumeration Date: | 04/24/2006 |
NPI Last Update Date: | 09/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | POD001017 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |