Provider Demographics
NPI:1053801498
Name:COLASURDO, JOSEPH NICHOLAS (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NICHOLAS
Last Name:COLASURDO
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 LAKE OCONEE PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-6490
Mailing Address - Country:US
Mailing Address - Phone:706-597-0102
Mailing Address - Fax:
Practice Address - Street 1:1610 MARS HILL RD STE A
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4891
Practice Address - Country:US
Practice Address - Phone:762-999-8090
Practice Address - Fax:706-597-1998
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD001547213E00000X, 213ES0103X
NY007215213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist