Basic Information
Provider Information
NPI: 1326278896
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURRY
FirstName: JOCELYN
MiddleName: KELLY
NamePrefix: DR.
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1975 HIGHWAY 54 W
Address2: STE 205
City: PEACHTREE CITY
State: GA
PostalCode: 302694794
CountryCode: US
TelephoneNumber: 6785619000
FaxNumber: 7704871232
Practice Location
Address1: 5910 HILLANDALE DR
Address2: STE 102
City: LITHONIA
State: GA
PostalCode: 300581884
CountryCode: US
TelephoneNumber: 7709819011
FaxNumber: 7709810480
Other Information
ProviderEnumerationDate: 07/19/2009
LastUpdateDate: 11/23/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213ES0103XPOD001106GAY Podiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery

No ID Information.


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