DR. WILLIAM KOVALCZYK (NPI# 1174504872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174504872 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM KOVALCZYK |
| Credential | DPM |
| Practice Address |
148 Mission Oak Dr Grayson GA 30017-4153 |
| Mailing Address |
Po Box 846 Snellville GA 30078-0846 |
| Practice Telephone | 6783765714 |
| Mailing Telephone | 6783765714 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2011-02-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 684 | GA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00521474A | 05 |
| Street Address |
148 MISSION OAK DR |
| City | GRAYSON |
| State | GA |
| Zip Code | 30017-4153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912176546 | Centerville Foot Care, P.C. | Durable Medical Equipment & Medical Supplies | 148 Mission Oak Dr, Grayson, GA 30017-4153 | 2008-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1811417132 | Yva Gauthier | Nurse Practitioner | 1620 Terry Mill Lane, Grayson, GA 30017 | 2017-06-27 |
| 1023341518 | Christine R Petro, Psy.d., LLC | Psychologist | 69 Grayson New Hope Rd, Grayson, GA 30017 | 2009-09-15 |
| 1902097579 | Zain Odeh Dabbas | Dentist | 2594 Loganviile Hwy, # 102, Grayson, GA 30017 | 2007-08-07 |
| 1619078276 | Primary Foot & Ankle Care | Podiatrist | 862 Amber Hill Ct, Grayson, GA 30017 | 2006-09-26 |
| 1700878170 | James Michael Long | Dentist | 2518 Loganville Hwy, Grayson, GA 30017 | 2005-08-22 |
| 1629556717 | Mason Moriah Earp | Physical Therapist | 2065 Grayson Hwy Ste B, Grayson, GA 30017 | 2018-08-01 |
| 1811482201 | Matthew Ntomoo Lo | Physical Therapy Assistant | 2065 Grayson Hwy Ste B, Grayson, GA 30017 | 2018-06-27 |
| 1144460668 | Alisa M Nelson-wade | Dentist | 2219 Loganville Hwy, Hwy 20, Grayson, GA 30017 | 2009-02-24 |
| 1003321662 | Grace Care Ambulance Transport, LLC | Ambulance | 516 Sosebee Farm Rd Unit 531, Grayson, GA 30017-0118 | 2017-12-05 |
| Find all providers in zip 30017 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619078276 | Primary Foot & Ankle Care | Podiatrist | 862 Amber Hill Ct, Grayson, GA 30017 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427696392 | Trent Lott | Podiatrist | 3045 Brook Dr, Decatur, GA 30033-3937 | 2019-12-11 |
| 1700440401 | Pamela Onderko Dpm LLC | Podiatrist | 5223 Riverside Dr Ste 104, Macon, GA 31210-0889 | 2019-04-28 |
| 1073070579 | Foot and Ankle Reconstruction of North Georgia P.c | Podiatrist | 970 Woodstock Pkwy Ste 200, Woodstock, GA 30188-4869 | 2019-02-21 |
| 1801352190 | Zachary Adam Rohr | Podiatrist | 2314 Emerald Springs Dr, Decatur, GA 30035-2632 | 2019-02-12 |
| 1649741604 | Neville A Alexander Dpm PC | Podiatrist | 535 Aston Hall Way, Alpharetta, GA 30022-6634 | 2018-12-16 |
| 1902371073 | Atlanta Sports Podiatry | Podiatrist | 9700 Medlock Bridge Rd Ste 126, Johns Creek, GA 30097-4408 | 2018-10-04 |
| 1275012254 | Christopher Anthony Martin | Podiatrist | 1075 Lafayette Pkwy Ste 200, Lagrange, GA 30241-3733 | 2018-08-09 |
| 1306323738 | Stride Foot & Ankle Center, LLC | Podiatrist | 4950 Gladstone Pkwy, Suwanee, GA 30024-6945 | 2018-07-28 |
| 1235642026 | Thomas Foot and Ankle Clinic LLC | Podiatrist | 410 Connell Rd Ste E, Valdosta, GA 31602-1898 | 2017-11-15 |
| 1013420413 | Erika Allison | Podiatrist | 3636 Highlands Pkwy Se, Smyrna, GA 30082-5184 | 2017-11-08 |
| Find all providers with the same taxonomy | ||||
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| 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.