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General NPI Number Information
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NPI Number | 1265629869
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Entity Type | Organization
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Legal Business Name | FOOT, ANKLE AND LEG SPECIALISTS OF GEORGIA
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 1800 TREE LN SUITE 320
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City | SNELLVILLE
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State | GA
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Zip | 30078-2016
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Country | US
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Telephone | 770-979-1890
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Fax | 770-979-2787
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Provider Business Mailing Address
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Address Line | 1800 TREE LN SUITE 320
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City | SNELLVILLE
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State | GA
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Zip | 30078-2016
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Country | US
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Telephone | 770-979-1890
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Fax | 770-979-2787
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS DOUGLAS CAIN
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Credential | DPM
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Telephone | 770-979-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 000509
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License Number State | GA
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