Provider Demographics
NPI:1326600313
Name:FOOT & ANKLE SPECIALISTS OF NORTHEAST GEORGIA, LLC
Entity Type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF NORTHEAST GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:678-619-1270
Mailing Address - Street 1:2312 SPARTA WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-2001
Mailing Address - Country:US
Mailing Address - Phone:678-619-1270
Mailing Address - Fax:
Practice Address - Street 1:2312 SPARTA WAY STE A
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-2001
Practice Address - Country:US
Practice Address - Phone:678-619-1270
Practice Address - Fax:678-619-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty