Healthcare Provider Details

I. General information

NPI: 1821244187
Provider Name (Legal Business Name): GEORGINA ASANTE, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 10TH AVE STE 305
COLUMBUS GA
31901-3611
US

IV. Provider business mailing address

1900 10TH AVE STE 305
COLUMBUS GA
31901-3611
US

V. Phone/Fax

Practice location:
  • Phone: 706-576-6844
  • Fax: 706-576-4779
Mailing address:
  • Phone: 706-576-6844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000628
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number000628
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number000628
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number000628
License Number StateGA

VIII. Authorized Official

Name: MISS DOROTHY ASANTE
Title or Position: ADMINISTRATOR
Credential:
Phone: 706-576-6844