Provider Demographics
NPI:1366149080
Name:VILLAGE PODIATRY GROUP LLC
Entity type:Organization
Organization Name:VILLAGE PODIATRY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:HELFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:678-426-2171
Mailing Address - Street 1:4101 CHARLOTTE AVE STE F185
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4066
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:615-269-3087
Practice Address - Street 1:110 OAK HILL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2313
Practice Address - Country:US
Practice Address - Phone:770-415-0594
Practice Address - Fax:833-645-2187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXTREMITY HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-13
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty