Provider Demographics
NPI:1396307252
Name:ELITE FOOT AND ANKLE SPECIALISTS LLC
Entity type:Organization
Organization Name:ELITE FOOT AND ANKLE SPECIALISTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-521-3668
Mailing Address - Street 1:175 PINE GROVE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-8483
Mailing Address - Country:US
Mailing Address - Phone:770-383-1883
Mailing Address - Fax:770-415-4095
Practice Address - Street 1:175 PINE GROVE RD STE 115
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-8483
Practice Address - Country:US
Practice Address - Phone:770-383-1883
Practice Address - Fax:770-415-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric