Provider Demographics
NPI:1821267147
Name:PERRY H. JULIEN, D.P.M.
Entity Type:Organization
Organization Name:PERRY H. JULIEN, D.P.M.
Other - Org Name:ATLANTA FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-255-9127
Mailing Address - Street 1:5600 ROSWELL RD NE
Mailing Address - Street 2:SUITE M-190
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1150
Mailing Address - Country:US
Mailing Address - Phone:404-255-9131
Mailing Address - Fax:404-255-0731
Practice Address - Street 1:5600 ROSWELL RD NE
Practice Address - Street 2:SUITE M-190
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1150
Practice Address - Country:US
Practice Address - Phone:404-255-9131
Practice Address - Fax:404-255-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000582213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1045280001Medicare NSC