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General NPI Number Information
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NPI Number | 1639814304
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Entity Type | Organization
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Legal Business Name | PODIATRY MEDICAL SURGICAL LLC
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Dates
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Enumeration Date | 04/28/2022
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 50 BERWICK BLVD STE 220
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City | SAVANNAH
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State | GA
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Zip | 31419-8483
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Country | US
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Telephone | 912-301-2880
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Fax | 888-830-1576
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Provider Business Mailing Address
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Address Line | 203 MARSHVIEW DR
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City | RICHMOND HILL
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State | GA
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Zip | 31324-6205
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Country | US
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Telephone | 912-301-2880
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Fax | 888-830-1576
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Authorized Official
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Title or Position | D.P.M.
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Name | DR. THOMAS JOHN LEGACKI III
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Credential |
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Telephone | 912-301-2880
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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 |
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License Number State |
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