Provider Demographics
NPI:1033530084
Name:NEWNAN CENTER FOR FOOT AND ANKLE SURGERY, LLC
Entity Type:Organization
Organization Name:NEWNAN CENTER FOR FOOT AND ANKLE SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DAMIAN
Authorized Official - Last Name:GIOVINCO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:678-561-9000
Mailing Address - Street 1:1975 HIGHWAY 54 W
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4794
Mailing Address - Country:US
Mailing Address - Phone:678-561-9000
Mailing Address - Fax:
Practice Address - Street 1:2326 HIGHWAY 34 E
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1328
Practice Address - Country:US
Practice Address - Phone:770-251-6100
Practice Address - Fax:770-251-3462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical