Provider Demographics
NPI:1720776354
Name:LOW COUNTRY FOOT SPECIALISTS, LLC
Entity Type:Organization
Organization Name:LOW COUNTRY FOOT SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERY
Authorized Official - Middle Name:B
Authorized Official - Last Name:KATALINICH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:843-293-6366
Mailing Address - Street 1:5046 HIGHWAY 17 BYP S STE 102
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-4503
Mailing Address - Country:US
Mailing Address - Phone:843-293-6366
Mailing Address - Fax:843-293-4469
Practice Address - Street 1:5046 HIGHWAY 17 BYP S STE 102
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4503
Practice Address - Country:US
Practice Address - Phone:843-293-6366
Practice Address - Fax:843-293-4469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty