Provider Demographics
NPI:1497011712
Name:QUINN, EMILY ANNE (DPM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:QUINN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 KENT RD STE 9
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-1697
Mailing Address - Country:US
Mailing Address - Phone:292-382-3338
Mailing Address - Fax:
Practice Address - Street 1:39 KENT RD
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-1698
Practice Address - Country:US
Practice Address - Phone:229-382-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1014213E00000X, 213E00000X
GAPOD001280213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist