Southern Podiatry Foot and Ankle LLC – Podiatrist

Key facts

NPI: 1619112968
Entity type: Organization (NPI type 2)
Primary specialty: Podiatrist 213E00000X
License: 5981134 (TN)
Legal business name: SOUTHERN PODIATRY FOOT AND ANKLE LLC
Practice address: 212 Lake Pehama Trail
Homer, GA 30547
Phone: (312) 752-7713
NPI assigned: Dec 15, 2008
Organization subpart: No

Authorized official

Name: Rick Thornton, DMP
Title: Owner
Phone: (312) 752-7713

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Southern Podiatry Foot and Ankle, PLLC Foot Surgery Podiatrist · Madison, AL · NPI 1497984397

NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Rick Thornton, DPM Podiatrist · Huntsville, AL · NPI 1518162858

NPD PODIATRIST

National Provider Directory

Tax ID family: Southern Podiatry Foot and Ankle LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Podiatrist Group: 193200000X MULTI-SPECIALTY GROUP	213E00000X	5981134	TN	Yes

Addresses

Primary practice location

212 Lake Pehama Trail
Homer, GA 30547

Mailing address

212 Lake Pehama Trail
Homer, GA 30547
Phone (312) 752-7713

Other providers in Homer, GA

All providers in Homer, GA · Podiatrist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.