Rudolph Cisco (NPI# 1043236706, PAC ID# 1557406592) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1043236706 |
| PAC ID by PECOS | 1557406592 |
| Professional Enrollment ID | I20100302000881 |
| Full Name | Rudolph Cisco |
| Organization Legal Name | VILLAGE PODIATRY GROUP, LLC. |
| Address |
550 Peachtree Nest Suite 1960 Atlanta GA 30308-2225 |
| Phone Number | 4045891330 |
| Gender | M |
| Graduation Year | 1986 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 4587646971 |
| Number of Group Practice Members | 41 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110029 | NORTHEAST GEORGIA MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 | 4045891330 | VILLAGE PODIATRY GROUP, LLC. |
| 1224 Sherwood Park Dr Ne, Gainesville, GA 30501-3445 | 7702870606 | VILLAGE PODIATRY GROUP, LLC. |
| Organization Legal Name | VILLAGE PODIATRY GROUP, LLC. |
| Physicians | 43 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sahar Mahzoon | Podiatry | Village Podiatry Group, LLC. | 625 Cook St, Royston, GA 30662-3932 |
| Jose Manuel Gonzalez | Podiatry | Village Podiatry Group, LLC. | 1610 Mulkey Rd, Austell, GA 30106-1182 |
| Ryan Hudson Fitzgerald | Podiatry | Village Podiatry Group, LLC. | 132 Riverstone Ter, Suite 101, Canton, GA 30114-1703 |
| Jason E Morris | Podiatry | Village Podiatry Group, LLC. | 1711 Mount Vernon Rd, Dunwoody, GA 30338-4242 |
| Christopher Russel Corwin | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| Sadia Ali | Podiatry | Village Podiatry Group, LLC. | 100 Greystone Power Blvd, Dallas, GA 30157-0908 |
| Andrew D Warner | Podiatry | Village Podiatry Group, LLC. | 3506 Old Milton Pkwy, Alpharetta, GA 30005-4458 |
| Steven A Weiskopf | Podiatry | Village Podiatry Group, LLC. | 1198 Buckhead Xing, D, Woodstock, GA 30189-4293 |
| Patricia W Morris | Podiatry | Village Podiatry Group, LLC. | 3949 Holcomb Bridge Rd, Suite 100, Norcross, GA 30092-2208 |
| Margo A Jimenez | Podiatry | Village Podiatry Group, LLC. | 2295 Parklake Nedr, Suite 150, Atlanta, GA 30345-2825 |
| Street Address |
550 PEACHTREE NEST SUITE 1960 |
| City | ATLANTA |
| State | GA |
| Zip | 30308-2225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Russel Corwin | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| Jenna M Morris | Physician Assistant | Resurgens, PC | 550 Peachtree Nest, Suite 19, Atlanta, GA 30308-2247 |
| Laura L Weakland | Hematology/oncology | Nsh Cancer Institute Professional Services G LLC | 550 Peachtree Nest, Suite 1185, Atlanta, GA 30308-2236 |
| Anthony M Cutsuries | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| Maria L. Pacheco | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| Aaron Solomon | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| La Genia D.p.m. Mitchell Smith | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| Leslie A Cone | Physical Medicine and Rehabilitation | Resurgens, PC | 550 Peachtree Nest, Suite 19, Atlanta, GA 30308-2247 |
| Sheetal M Patel | Hematology/oncology | Nsh Cancer Institute Professional Services G LLC | 550 Peachtree Nest, Suite 7200, Atlanta, GA 30308-2247 |
| John A Ruch | Podiatry | Village Podiatry Group, LLC. | 550 Peachtree Nest, Suite 1960, Atlanta, GA 30308-2225 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dexter Page | Obstetrics/gynecology | 550 Peactree St Ne, Suite 1275, Atlanta, GA 30308 | |
| Frederick T Work Jr. | Plastic and Reconstructive Surgery | One Baltimore Place, Suite 400, Atlanta, GA 30308 | |
| Shelby R Wilkes | Ophthalmology | Atlanta Eye Consultants | 830 W Peachtree St Nw, Suite 100, Atlanta, GA 30308-1129 |
| Jettie M Burnett | Ophthalmology | Atlanta Eye Consultants | 830 W Peachtree St Nw, Suite 100, Atlanta, GA 30308-1129 |
| Mary E Gower | Occupational Therapy | Center for The Visually Impaired | 739 W Peachtree St Nw, Atlanta, GA 30308-1137 |
| Alexandra Gale Dempsey | Physical Therapy | Independent Physical Therapy of Georgia, LLC | 800 Peachtree St Ne, Suite E2, Atlanta, GA 30308-1245 |
| James Brooks | Physical Therapy | Independent Physical Therapy of Georgia, LLC | 800 Peachtree St Ne, Suite E2, Atlanta, GA 30308-1245 |
| Amelia Persaud | Occupational Therapy | Independent Physical Therapy of Georgia, LLC | 800 Peachtree St Ne, Suite E2, Atlanta, GA 30308-1245 |
| Danielle Leigh Drobbin | Chiropractic | 814 Juniper St Ne, Suite 201, Atlanta, GA 30308-1300 | |
| Dan Shuman | Chiropractic | 100 6th Street Ne, Suite 150, Atlanta, GA 30308-1302 | |
| Find all physicians in zip 30308 | |||
| City | ATLANTA |
| Zip Code | 30308 |
| Specialty | PODIATRY |
| City + Specialty | ATLANTA + PODIATRY |
Please comment or provide details below to improve the information on Rudolph Cisco.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.