McDuffie Podiatry and Wound Care, PC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

000848 Issued in GA

Legal business name

MCDUFFIE PODIATRY AND WOUND CARE, PC

Practice address

544 W Hill St
Thomson, GA 30824-2117

Phone

(706) 595-8787

Fax

(706) 595-8757

NPI assigned

Oct 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. George S Havrilla, DPMNPI 1306841374

Title

Owner

Phone

(706) 595-8787

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• George S Havrilla, DPM

  • Primary Podiatric Medicine Podiatrist
  • Thomson, GA
  • NPI 1306841374
  Medicare reassignment NPD Authorized official
• Ryan Huntsman, D.P.M.

  • Podiatrist
  • Salem, OR
  • NPI 1609281534

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1760670673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 W HILL ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242117",
            "telephone_number": "706-595-8787",
            "fax_number": "706-595-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 W HILL ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242117",
            "telephone_number": "706-595-8787",
            "fax_number": "706-595-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDUFFIE PODIATRY AND WOUND CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "HAVRILLA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-595-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "GA",
            "license": "000848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10041458",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF GEORGIA",
            "identifier": "322007",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618552906A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "GRP6239",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GA",
            "identifier": "52773057-003",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "10581911",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5467067",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McDuffie County Board of Health
• McDuffie County Mental Health
• McDuffie County Nursing Home LLC
• McDuffie Coutny Board of Education
• McDuffie Medical Associates, PC
• McDuffie Surgical Clinic PC
• Michael Keith McGahee, RPH
• Merritt Echols McLaughlin, MD
• Michael S McQuaig, O.D.
• Mark T Messenger, D.P.M.

• Primary Podiatric Medicine Podiatrist in Thomson, GA
• Providers in Thomson, GA by specialty
• Primary Podiatric Medicine Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.