MEDICARE: THE FOOT & ANKLE CENTER, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	945	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DF3241	OTHER	GA	RAILROAD MEDICARE GROUP
3	P00355897	OTHER	GA	MEDICARE RAILROAD PIN
4	5784660001	OTHER	GA	DMERC MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	052053396005	OTHER	GA	BLUE CROSS BLUE SHIELD
5	1831106988	OTHER	GA	INDIVIDUAL NPI
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	DF3241	OTHER	GA	MEDIARE RAILROAD GROUP NUMBER

General Provider Information

NPI Number	:	1437169075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FOOT & ANKLE CENTER, PC

Provider Business Mailing Address
First Line	:	1000 TOWNE CENTER BLVD
Second Line	:	SUITE 505
City	:	POOLER
State	:	GA
Zip	:	31322-4052
Country	:	US
Telephone Number	:	912-330-8885
Fax Number	:	912-330-8858

Provider Business Practice Location Address
First Line	:	1000 TOWNE CENTER BLVD
Second Line	:	SUITE 505
City	:	POOLER
State	:	GA
Zip	:	31322-4052
Country	:	US
Telephone Number	:	912-330-8885
Fax Number	:	912-330-8858

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEONARD MICHAEL TALARICO
Credential	:
Telephone Number	:	912-330-8885

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	02/23/2023

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Directions to “THE FOOT & ANKLE CENTER, PC ” Practice Location

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