Modern Podiatry, Llc

LBN: Modern Podiatry, Llc
Modern Podiatry, Llc is an health care organization with primary practice located at 366 Racetrack Rd , Mcdonough GA 30252-1022. The organization recently has only one registered license in Ambulatory Health Care Facilities / Podiatric, which is considered as the primary health care specialty. Modern Podiatry, Llc can be contacted via phone (470) 781-5585, or through Wanzu, Kibibi via phone (470) 781-5585.

Contact Information

Primary practice address
366 Racetrack Rd Mcdonough GA 30252-1022
Phone: (470) 781-5585
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wanzu, Kibibi Doctor of Podiatric Medicine (DPM)
Phone: (470) 781-5585

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Podiatric 261QP1100X

Profile Details

NPI number 1811538390
LBN Legal business name Modern Podiatry, Llc
DBA Doing business as
Authorized official Wanzu, Kibibi Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2019
Last updated May 13th, 2024 - about 7 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811538390 NPPES
Georgia MEDICAID 003233587A

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