Southeast Podiatry

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

POD001011 Issued in GA

Legal business name

SOUTHEAST PODIATRY

Practice address

3225 Shallowford Rd
Suite 200
Marietta, GA 30062-1266

Phone

(770) 675-7904

Fax

(770) 675-7906

NPI assigned

Jan 7, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Suzanne Marie Clous, D.P.M.

Title

Podiatrist

Phone

(770) 852-7035

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1154568582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621266",
            "telephone_number": "770-675-7904",
            "fax_number": "770-675-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621266",
            "telephone_number": "770-675-7904",
            "fax_number": "770-675-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "CLOUS",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "770-852-7035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "POD001011",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "POD001011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison T Southard
• Southeast Foot and Ankle, PC
• Southeast Healthcare LLC
• Southeast Integrative Medicine
• Southeast Personal Care and Nursing Services LLC
• Southern Behavioral Group
• Southern Comfort Senior Living LLC
• Southern Health Care of Georgia
• Southern Hospital Physicians,LLC
• Southern Pelvic Health, LLC

• Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.