Provider Demographics
NPI:1821244187
Name:GEORGINA ASANTE, DPM, PC
Entity Type:Organization
Organization Name:GEORGINA ASANTE, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-576-6844
Mailing Address - Street 1:1900 10TH AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3611
Mailing Address - Country:US
Mailing Address - Phone:706-576-6844
Mailing Address - Fax:
Practice Address - Street 1:1900 10TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3611
Practice Address - Country:US
Practice Address - Phone:706-576-6844
Practice Address - Fax:706-576-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000628213E00000X, 332B00000X, 332BC3200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000452856CMedicaid
GA673506OtherBLUE CROSS BLUE SHIELD
4987960001Medicare NSC
GA673506OtherBLUE CROSS BLUE SHIELD