Healthcare Provider Details

I. General information

NPI: 1659918969
Provider Name (Legal Business Name): VILLAGE PODIATRY GROUP II, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 COOK ST STE 617
ROYSTON GA
30662-3932
US

IV. Provider business mailing address

900 CIRCLE 75 PKWY SE STE 900
ATLANTA GA
30339-3084
US

V. Phone/Fax

Practice location:
  • Phone: 762-338-2333
  • Fax: 762-338-2342
Mailing address:
  • Phone: 678-426-2171
  • Fax: 404-446-1957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DAVID N. HELFMAN
Title or Position: CEO
Credential: DPM
Phone: 770-384-0284