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General NPI Number Information
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NPI Number | 1699423194
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Entity Type | Organization
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Legal Business Name | VILLAGE PODIATRY GROUP LLC
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 100 MARKET PLACE BLVD STE 302
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City | CARTERSVILLE
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State | GA
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Zip | 30121-8717
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Country | US
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Telephone | 770-771-6991
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 UPPER HEMBREE RD STE 100
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City | ROSWELL
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State | GA
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Zip | 30076-0929
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Country | US
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Telephone | 678-426-2171
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Fax | 404-446-1957
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Authorized Official
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Title or Position | CEO
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Name | DAVID N HELFMAN
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Credential | DPM
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Telephone | 678-426-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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