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General NPI Number Information
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NPI Number | 1710421458
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE PODIATRY, LLC
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 3479 SHARON RD
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City | AUGUSTA
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State | GA
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Zip | 30909-9539
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Country | US
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Telephone | 706-738-4604
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Fax |
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Provider Business Mailing Address
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Address Line | 3479 SHARON RD
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City | AUGUSTA
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State | GA
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Zip | 30909-9539
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Country | US
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Telephone | 706-738-4604
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA D. MORGAN
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Credential | DPM
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Telephone | 706-738-4604
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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 | POD000736G
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License Number State | GA
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