MCDUFFIE PODIATRY AND WOUND CARE, PC (NPI# 1760670673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760670673 |
| Entity Type | Organization |
| Organization Name | MCDUFFIE PODIATRY AND WOUND CARE, PC |
| Practice Address |
544 W Hill St Thomson GA 30824-2117 |
| Practice Telephone | 7065958787 |
| Practice Fax Number | 7065958757 |
| Mailing Telephone | 7065958787 |
| Mailing Fax Number | 7065958757 |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2013-02-06 |
| Authorized Official Name | DR. GEORGE S HAVRILLA (OWNER) |
| Authorized Official Telephone | 7065958787 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
000848 | GA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | BLUE CROSS BLUE SHIELD GA | 52773057-003 | 01 |
| GA | AMERIGROUP | 10041458 | 01 |
| GA | WELLCARE OF GEORGIA | 322007 | 01 |
| GA | AETNA | 5467067 | 01 |
| GA | 618552906A | 05 | |
| GA | MEDICARE GROUP # | GRP6239 | 01 |
| GA | CIGNA | 10581911 | 01 |
| Street Address |
544 W HILL ST |
| City | THOMSON |
| State | GA |
| Zip Code | 30824-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841374 | George S Havrilla | Podiatrist | 544 W Hill St, Thomson, GA 30824-2117 | 2005-06-16 |
| 1629450655 | Alexandra Scrimalli Kaikis | Podiatrist | 544 W Hill St, Thomson, GA 30824-2117 | 2015-06-25 |
| 1811384530 | Andreas Kaikis | Podiatrist | 544 W Hill St, Thomson, GA 30824 | 2015-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306591 | Connie Deverell Tam | Pharmacist | Walmart Pharmacy #1658, 2205 Harrison Rd, Thomson, GA 30824 | 2020-11-02 |
| 1750878039 | Amber Nichole Wood | Student in an Organized Health Care Education/Training Program | 355 Bard Avenue Department of Psychiatry, 1st Floor, Staten Island, NY 30824 | 2018-04-22 |
| 1861854176 | Family Care Group of Thomson,inc | Family Medicine | 2508 University Dr, Thomson, GA 30824 | 2016-03-25 |
| 1174900674 | Carolyn Louise Samuels | Behavioral Analyst | 1139 Washington Rd, Thomson, GA 30824 | 2015-05-04 |
| 1013343953 | David Carroll Hughes | Dentist | 540 West Hill St., Thomson, GA 30824 | 2013-09-24 |
| 1295067270 | Wesley Alan Mccarthy | Counselor | 114 East Hall Street, Thompson, GA 30824 | 2010-02-02 |
| 1417280439 | Charles Edward Jones | Counselor | 114 East Hall St, Thomson, GA 30824 | 2009-09-09 |
| 1700055779 | Drs Jopling and Brunson | Dentist | 115 Gordon Street, Thomson, GA 30824 | 2008-02-25 |
| 1871630483 | Robert F. Polglase | Emergency Medicine | 521 Hill St, S.w., Thomson, GA 30824 | 2007-01-31 |
| 1861553141 | The Homeplace Adult Daycare, Inc. | Custodial Care Facility | 1324 Wrightsboro Road, Thomson, GA 30824 | 2006-12-12 |
| Find all providers in zip 30824 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841374 | George S Havrilla | Podiatrist | 544 W Hill St, Thomson, GA 30824-2117 | 2005-06-16 |
| 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 | ||||
Please comment or provide details below to improve the information on MCDUFFIE PODIATRY AND WOUND CARE, PC.
| 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.