Comprehensive Podiatry, LLC
Podiatrist in Stone Mountain, GA. Organization (NPI-2).
NPI number1366614752
StatusActive
Last updated in NPPESJul 9, 2018
Details
- NPI
- 1366614752
- Entity type
- Organization (NPI-2)
- Legal business name
- Comprehensive Podiatry, LLC
- Organization subpart
- No
- Enumeration date
- Mar 26, 2008
- Last updated
- Jul 9, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213E00000X | Podiatrist | POD001076 | GA | Yes |
Other names
- Comprehensive Podiatry Clinic, LLC (Doing Business As)
Practice location
624 El Prado CtStone Mountain, GA 30083
Phone 404-435-6389
Mailing address
624 El Prado CtStone Mountain, GA 30083-3822
Phone 404-435-6389
Authorized official
Tony Gayle
Owner
6789380159
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