Organization · Type 2 NPI
Providence Foot & Ankle Centers, P.c., Inc.
Foot & Ankle Surgery Podiatrist · Lithia Springs, GA
NPI number
1790931483
Active
Practice location
865 Thornton Rd, Suite B
Lithia Springs, GA 30122-2607
Fax (770) 790-4752
Mailing address
3886 Princeton Lakes Way SW, Suite 140A
Atlanta, GA 30331-5511
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | None listed |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | None listed |
| Radiology Podiatrist | 213ER0200X | None listed |
| Sports Medicine Podiatrist | 213ES0000X | None listed |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | None listed |
Foot & Ankle Surgery Podiatrist: Definition to come...
About NPI 1790931483
Providence Foot & Ankle Centers, P.c., Inc.'s National Provider Identifier is 1790931483, issued on Aug 13, 2008. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Lithia Springs, GA. The record was last updated on Apr 19, 2012.