Charles Jeffrey Sidlow
Primary Podiatric Medicine
958 Joe Frank Harris Pkwy Se Bldg A Suite 106
Cartersville
, Georgia 30120-2175
Charles Jeffrey Sidlow
Primary Podiatric Medicine
958 Joe Frank Harris Pkwy Se Bldg A Suite 106
Cartersville
, Georgia 30120-2175
(770) 386-4894
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About
Features
Specialties
- Primary Podiatric Medicine
Languages spoken
- English
Location
First Address
- Charles Jeffrey Sidlow
- 958 Joe Frank Harris Pkwy Se Bldg A Suite 106
- Cartersville, GA
- Zip : 30120-2175
- Fax : (770) 386-4894
- Phone : (770) 386-1389
Second Address
- Charles Jeffrey Sidlow
- 958 Joe Frank Harris Pkwy Se Bldg A Suite 106
- Cartersville, GA
- Zip : 30120-2175
- Fax : (770) 386-4894
- Phone : (770) 386-1389
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | POD000560 | GA |
National Provider Identifier
| NPI | 1033179270 |
|---|---|
| Provider Name | Charles Jeffrey Sidlow |
| First Address | Cartersville, GA 30120-2175 |
| Second Address | Cartersville, GA 30120-2175 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/03/2006 |
| Last Update Date | 19/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000333803A | (05) | GA |
| U19472 | (02) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.