Provider Demographics
NPI:1689149601
Name:ATLANTA PREMIER FOOT AND ANKLE SURGERY
Entity Type:Organization
Organization Name:ATLANTA PREMIER FOOT AND ANKLE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NRUP
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLAT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:404-245-4969
Mailing Address - Street 1:2170 SUGAR MAPLE CV NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8815
Mailing Address - Country:US
Mailing Address - Phone:140-424-5496
Mailing Address - Fax:
Practice Address - Street 1:100 STONEFOREST DR STE 120
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-4881
Practice Address - Country:US
Practice Address - Phone:404-245-4969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty