Healthcare Provider Details

I. General information

NPI: 1427540699
Provider Name (Legal Business Name): VILLAGE PODIATRY GROUP II, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 PEACHTREE ROAD NE SUITE 810
ATLANTA GA
30309-1412
US

IV. Provider business mailing address

4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US

V. Phone/Fax

Practice location:
  • Phone: 404-446-1890
  • Fax: 404-446-1898
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MITCHELL P. HILSEN
Title or Position: OWNER/DPM
Credential:
Phone: 404-822-5555