Healthcare Provider Details

I. General information

NPI: 1003908138
Provider Name (Legal Business Name): JAMES AUSTIN DENMARK D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 WRIGHTSBORO RD SUITE 154
AUGUSTA GA
30904-4764
US

IV. Provider business mailing address

2260 WRIGHTSBORO RD SUITE 154
AUGUSTA GA
30904-4764
US

V. Phone/Fax

Practice location:
  • Phone: 706-364-0263
  • Fax:
Mailing address:
  • Phone: 706-364-0263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPOD000953
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: