Dr. Joseph Distefano
Foot & Ankle Surgery
958 Joe Frank Harris Pkwy Se Bldg A106
Cartersville
, Georgia 30120-2151
Dr. Joseph Distefano
Foot & Ankle Surgery
958 Joe Frank Harris Pkwy Se Bldg A106
Cartersville
, Georgia 30120-2151
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Dr. Joseph Distefano
- 5348 Tally Green Drive
- Marietta, GA
- Zip : 30068-2879
- Phone :
Second Address
- Dr. Joseph Distefano
- 958 Joe Frank Harris Pkwy Se Bldg A106
- Cartersville, GA
- Zip : 30120-2151
- 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 | 213ES0103X | Foot & Ankle Surgery | 01669 | MD |
National Provider Identifier
| NPI | 1013357383 |
|---|---|
| Provider Name | Dr. Joseph Distefano |
| First Address | Marietta, GA 30068-2879 |
| Second Address | Cartersville, GA 30120-2151 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/07/2013 |
| Last Update Date | 13/10/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01669 | MARYLAND BOARD OF PODIATRY (01) | MD |
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.