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General NPI Number Information
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NPI Number | 1366484867
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Entity Type | Organization
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Legal Business Name | JOSEPH D GIOVINCO DPM PC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 265 N JEFF DAVIS DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1625
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Country | US
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Telephone | 770-716-8732
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Fax | 770-716-1330
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Provider Business Mailing Address
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Address Line | 7130 MOUNT ZION BLVD STE 14
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City | JONESBORO
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State | GA
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Zip | 30236-2566
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Country | US
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Telephone | 770-716-8732
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Fax | 770-716-1330
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CONSUELO DODSON
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Credential |
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Telephone | 678-854-1976
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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 | 000623
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License Number State | GA
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