Healthcare Provider Details

I. General information

NPI: 1073586715
Provider Name (Legal Business Name): HOLCOMBS FOOT AND LEG CLINICS OF CUMMING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 HEFNER ST STE 202
ELLIJAY GA
30540
US

IV. Provider business mailing address

236 ATLANTA ROAD
CUMMING GA
30040
US

V. Phone/Fax

Practice location:
  • Phone: 678-880-0036
  • Fax: 678-493-7051
Mailing address:
  • Phone: 770-889-9596
  • Fax: 770-889-9547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000925
License Number StateGA

VIII. Authorized Official

Name: DR. BRET J HINTZE
Title or Position: OWNER
Credential: DPM
Phone: 770-889-9596