Healthcare Provider Details

I. General information

NPI: 1629386495
Provider Name (Legal Business Name): ALL WAYS FEET OF GEORGIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 MACARTHUR DR
HINESVILLE GA
31313-4410
US

IV. Provider business mailing address

127 MACARTHUR DR
HINESVILLE GA
31313-4410
US

V. Phone/Fax

Practice location:
  • Phone: 912-876-8637
  • Fax: 912-876-4069
Mailing address:
  • Phone: 912-876-8637
  • Fax: 912-876-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number649
License Number StateGA

VIII. Authorized Official

Name: DR. HENRY TAYLOR II
Title or Position: OWNER
Credential: DPM
Phone: 912-876-8637