Provider Demographics
NPI:1295773802
Name:GEORGIA FOOT CARE, INC.
Entity type:Organization
Organization Name:GEORGIA FOOT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COMBSBARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:770-307-1094
Mailing Address - Street 1:4704 CHATEAU FOREST WAY
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-6232
Mailing Address - Country:US
Mailing Address - Phone:770-307-1094
Mailing Address - Fax:770-307-1443
Practice Address - Street 1:4704 CHATEAU FOREST WAY
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-6232
Practice Address - Country:US
Practice Address - Phone:770-307-1094
Practice Address - Fax:770-307-1443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000730213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty