Provider Demographics
NPI:1659525921
Name:AMERICAN FOOT & LEG SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:AMERICAN FOOT & LEG SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-363-9944
Mailing Address - Street 1:425 FOREST PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-2185
Mailing Address - Country:US
Mailing Address - Phone:404-363-9944
Mailing Address - Fax:404-363-9951
Practice Address - Street 1:1109 EAGLES LANDING PKWY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281
Practice Address - Country:US
Practice Address - Phone:404-363-9944
Practice Address - Fax:770-507-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000723213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11D2114365OtherCLIA
GAGRP884OtherMEDICARE GROUP NUMBER
GAGRP884OtherMEDICARE GROUP NUMBER