Healthcare Provider Details

I. General information

NPI: 1821277591
Provider Name (Legal Business Name): ALBANY PODIATRY ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 7TH AVE
ALBANY GA
31701-1921
US

IV. Provider business mailing address

531 7TH AVE
ALBANY GA
31701-1921
US

V. Phone/Fax

Practice location:
  • Phone: 229-883-3535
  • Fax: 229-883-3783
Mailing address:
  • Phone: 229-883-3535
  • Fax: 229-883-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JON KENNETH DURHAM
Title or Position: PARTNER
Credential: D.P.M.
Phone: 229-883-3535