Provider Demographics
NPI:1396828968
Name:ANKLE & FOOT CENTERS OF NORTH GEORGIA PC
Entity Type:Organization
Organization Name:ANKLE & FOOT CENTERS OF NORTH GEORGIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-265-6600
Mailing Address - Street 1:133 PROMINENCE COURT
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-8936
Mailing Address - Country:US
Mailing Address - Phone:706-265-6600
Mailing Address - Fax:706-265-6604
Practice Address - Street 1:133 PROMINENCE COURT
Practice Address - Street 2:SUITE 210
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-8936
Practice Address - Country:US
Practice Address - Phone:706-265-6600
Practice Address - Fax:706-265-6604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA411385986BMedicaid
GA411385986AMedicaid
GA411385986DMedicaid
U76483Medicare UPIN
GA411385986AMedicaid