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NPI 1518082353

NPI 1518082353 : PERSONAL FOOT & ANKLE SPECIALIST,PC : WRIGHTSVILLE, GA

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General NPI Number Information
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    NPI Number           |    1518082353
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    Entity Type          |    Organization 
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    Legal Business Name  |    PERSONAL FOOT & ANKLE SPECIALIST,PC 
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Dates
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    Enumeration Date     |    03/20/2007
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    Last Update Date     |    10/05/2009
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Provider Practice Location Address
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    Address Line         |    314 S MARCUS ST 
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    City                 |    WRIGHTSVILLE
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    State                |    GA
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    Zip                  |    31096-1517
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    Country              |    US
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    Telephone            |    478-864-1114
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    Fax                  |    478-552-6333
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Provider Business Mailing Address
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    Address Line         |    PO BOX 5969 
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    City                 |    SANDERSVILLE
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    State                |    GA
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    Zip                  |    31082-5969
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    Country              |    US
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    Telephone            |    478-864-1114
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    Fax                  |    478-552-6333
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. THUY D GIANG 
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    Credential           |    DPM
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    Telephone            |    478-552-1086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213EP1101X
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    Taxonomy Name        |    Primary Podiatric Medicine Podiatrist
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    License Number       |    000790
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    License Number State |    GA
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