Provider Demographics
NPI:1982602561
Name:DIPALMA, FRANK JOHN SR (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:DIPALMA
Suffix:SR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 PRINCE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6015
Mailing Address - Country:US
Mailing Address - Phone:706-354-1540
Mailing Address - Fax:706-354-8639
Practice Address - Street 1:2003 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6015
Practice Address - Country:US
Practice Address - Phone:706-354-1540
Practice Address - Fax:706-354-8639
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000591213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1675710001Medicare NSC
GAT29939Medicare UPIN
GA48SCBPQMedicare ID - Type Unspecified