Provider Demographics
NPI:1457308132
Name:PERSONAL FOOT AND ANKLE SPECIALIST
Entity Type:Organization
Organization Name:PERSONAL FOOT AND ANKLE SPECIALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:478-552-1086
Mailing Address - Street 1:PO BOX 5969
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-5969
Mailing Address - Country:US
Mailing Address - Phone:478-552-1086
Mailing Address - Fax:478-552-6333
Practice Address - Street 1:1240 GA HIGHWAY 15 N
Practice Address - Street 2:
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-7303
Practice Address - Country:US
Practice Address - Phone:478-552-1086
Practice Address - Fax:478-552-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000790213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA958015OtherBCBS GA
GA000723907BMedicaid
GA000723907BMedicaid
GAU64208Medicare UPIN
GA000723907BMedicaid
GA4343690001Medicare NSC