Provider Demographics
NPI:1740450071
Name:COMPREHENSIVE FOOT & ANKLE, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE FOOT & ANKLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PALMER
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:770-921-8800
Mailing Address - Street 1:4705 LAWRENCEVILLE HWY NW
Mailing Address - Street 2:SUITE C
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3667
Mailing Address - Country:US
Mailing Address - Phone:770-921-8800
Mailing Address - Fax:770-921-8801
Practice Address - Street 1:6630 MCGINNIS FERRY RD
Practice Address - Street 2:SUITE B
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1542
Practice Address - Country:US
Practice Address - Phone:770-476-7229
Practice Address - Fax:770-921-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000918213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty