Provider Demographics
NPI:1467644880
Name:FOCUS FOOT & ANKLE CENTERS, LLC
Entity Type:Organization
Organization Name:FOCUS FOOT & ANKLE CENTERS, LLC
Other - Org Name:CHASTAIN PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:404-252-6662
Mailing Address - Street 1:5491 ROSWELL RD NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1911
Mailing Address - Country:US
Mailing Address - Phone:404-252-6662
Mailing Address - Fax:
Practice Address - Street 1:5491 ROSWELL RD NE
Practice Address - Street 2:SUITE B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1911
Practice Address - Country:US
Practice Address - Phone:404-252-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000877213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00838131CMedicaid
GAGRP 3733OtherMEDICARE
GAGRP 3733OtherMEDICARE
GA00838131CMedicaid