MEDICARE: DR. CAROLINE R KISER D.P.M.

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	213E00000X	Podiatrist	PO4695	FL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	865	TN
3	213ES0103X	Foot & Ankle Surgery Podiatrist	PO4695	FL

General Provider Information

NPI Number	:	1922425560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLINE R KISER D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 746647
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6647
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4275

Provider Business Practice Location Address
First Line	:	1747 BAPTIST CLAY DR STE 200
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8505
Country	:	US
Telephone Number	:	904-202-6683
Fax Number	:	904-376-3062

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	10/24/2025

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Directions to “ DR. CAROLINE R KISER D.P.M.” Practice Location

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