Provider Demographics
NPI:1255642609
Name:PONDER, ERINN NICOLE (DPM)
Entity type:Individual
Prefix:DR
First Name:ERINN
Middle Name:NICOLE
Last Name:PONDER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ERINN
Other - Middle Name:N
Other - Last Name:PONDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ERINNNPONDERWILLIAMS
Mailing Address - Street 1:4707 ASHFORD DUNWOODY RD UNIT 467486
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5503
Mailing Address - Country:US
Mailing Address - Phone:470-588-5477
Mailing Address - Fax:470-200-3627
Practice Address - Street 1:4707 ASHFORD DUNWOODY RD UNIT 467486
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5503
Practice Address - Country:US
Practice Address - Phone:470-588-5477
Practice Address - Fax:470-200-3627
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3614213ES0103X
GA001238213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery