CHARLES JEFFREY SIDLOW (NPI# 1033179270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033179270 |
Entity Type | Individual |
Full Name | CHARLES JEFFREY SIDLOW |
Credential | D.P.M. |
Practice Address |
958 Joe Frank Harris Pkwy Se Bldg A Suite 106 Cartersville GA 30120-2175 |
Practice Telephone | 7703861389 |
Practice Fax Number | 7703864894 |
Mailing Telephone | 7703861389 |
Mailing Fax Number | 7703864894 |
Enumeration Date | 2006-03-23 |
Last Update Date | 2012-12-19 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
POD000560 | GA | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 000333803A | 05 |
Street Address |
958 JOE FRANK HARRIS PKWY SE BLDG A SUITE 106 |
City | CARTERSVILLE |
State | GA |
Zip Code | 30120-2175 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578862421 | Renee Clarke-hall | Nurse Practitioner | 958 Joe Frank Harris Pkwy Se Bldg A, Sute 101, Cartersville, GA 30120-2175 | 2011-03-17 |
1740580018 | Ashley Nicole Saint | Advanced Practice Midwife | 958 Joe Frank Harris Pkwy Se Bldg A, Building 2 Suite 102, Cartersville, GA 30120-2175 | 2010-11-02 |
1316276512 | Women's Surgical Center | Clinic/Center | 958 Joe Frank Harris Pkwy Se Bldg A, Suite 107, Cartersville, GA 30120-2175 | 2009-12-17 |
1952504201 | Harbin Clinic, LLC | Durable Medical Equipment & Medical Supplies | 958 Joe Frank Harris Pkwy Se Bldg A, Suite 101, Cartersville, GA 30120-2151 | 2007-06-06 |
1063539849 | Paul Richard Boecler | Dentist | 958 Joe Frank Harris Pkwy Se Bldg A, Suite 104, Cartersville, GA 30120-2151 | 2007-03-25 |
1790845030 | Suzanne Alsayed | Internal Medicine | 958 Joe Frank Harris Pkwy Se Bldg A, Suite 101, Cartersville, GA 30120-2151 | 2006-12-09 |
1962415059 | Hugo D Ribot Jr. | Obstetrics & Gynecology | 958 Joe Frank Harris Pkwy Se Bldg A, Suite 102, Cartersville, GA 30120-2151 | 2006-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295357325 | Rhonda Ireland | Pharmacist | 125 Main Street Marketplace, Cartersville, GA 30120 | 2020-05-12 |
1538719273 | The Golden Ages Corporoation | Nursing Care | 41 Walden Crossing, Cartrsville, GA 30120 | 2019-09-15 |
1932752391 | Jennifer Elaine Mclaurin | Counselor | 911 N. Tennesse Street, Suite 107, Cartersville, GA 30120 | 2019-07-24 |
1164989497 | Kayla Elizabeth Hoskins | Occupational Therapist | 7 E Cherokee Ave, Cartersville, GA 30120 | 2019-02-22 |
1942785837 | Adriane L Alexander | Social Worker | 24 Meadowbridge Drive, Cartersville, GA 30120 | 2018-09-26 |
1306329362 | Ashley Elizabeth Deal | Nurse Practitioner | 958a Joe Frank Harris Parkway, Suite 101, Cartersville, GA 30120 | 2018-09-14 |
1376037606 | Samuel Gilreath Tumlin | Dentist | 701 N. Tennessee St., Cartersville, GA 30120 | 2018-06-20 |
1437669108 | Deborah Susan Luper | Counselor | 106 Forrest Avenue, A Healing Place, Cartersville, GA 30120 | 2017-10-06 |
1750810693 | Debbie Fearon | Registered Nurse | 523 Mountain Chase, Cartersville, GA 30120 | 2017-06-05 |
1023486388 | Amanda Stanley | Pharmacist | 1150 West Ave, Cartersville, GA 30120 | 2015-09-03 |
Find all providers in zip 30120 |
Taxonomy Code | 213EP1101X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Primary Podiatric Medicine |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033741632 | Serenity Podiatry and Med Spa LLC | Podiatrist | 770 Old Roswell Pl Ste A300, Roswell, GA 30076-1697 | 2020-02-11 |
1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
1396088803 | Jae Y Shin | Podiatrist | 506 Osigian Blvd Ste 5, Warner Robins, GA 31088-8985 | 2013-04-03 |
1598010720 | Swga Foot & Ankle Center | Podiatrist | 415 E 4th Ave Ste B, Cordele, GA 31015-0614 | 2012-07-13 |
1548524937 | Swga Foot & Ankle Center | Podiatrist | 922 E Jefferson St Ste D, Americus, GA 31709-4781 | 2012-06-29 |
1952667305 | Agape Foot & Ankle Clinic, LLC | Podiatrist | 3693 Wittenburg Ct, Decatur, GA 30034-5507 | 2012-04-10 |
1275780199 | Azuka Ifeyinwa Nwaedozie | Podiatrist | 3364 Medina Dr, Jonesboro, GA 30236-6873 | 2008-08-21 |
1386804045 | Howard Foot&leg Specialists,pc. | Podiatrist | 12476 Hopewell Rd, Alpharetta, GA 30004-1347 | 2008-06-16 |
1053506162 | Diabetic Foot Care Specialist of Georgia | Podiatrist | 238 Walker St Sw, Unit #12, Atlanta, GA 30313-1266 | 2007-09-11 |
1356549141 | Dwayne Lay | Podiatrist | 210 Oakside Ln Ste B, Canton, GA 30114-6417 | 2007-07-03 |
Find all providers with the same taxonomy |
City | CARTERSVILLE |
Zip Code | 30120 |
Please comment or provide details below to improve the information on CHARLES JEFFREY SIDLOW.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.