Provider Demographics
NPI:1447762927
Name:IFOUNDATION PODIATRY LLC
Entity Type:Organization
Organization Name:IFOUNDATION PODIATRY LLC
Other - Org Name:IFOUNDATION PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERINN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PONDER - WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:470-588-5477
Mailing Address - Street 1:1000 ASHWOOD PKWY APT 1406
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7517
Mailing Address - Country:US
Mailing Address - Phone:727-509-9340
Mailing Address - Fax:470-200-3627
Practice Address - Street 1:1000 ASHWOOD PKWY APT 1406
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-7517
Practice Address - Country:US
Practice Address - Phone:470-588-5477
Practice Address - Fax:470-200-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD001238213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty