Provider Demographics
NPI:1932281797
Name:COLUMBUS FOOT & ANKLE PC
Entity Type:Organization
Organization Name:COLUMBUS FOOT & ANKLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-653-5501
Mailing Address - Street 1:1013 CENTRE BROOK CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-4573
Mailing Address - Country:US
Mailing Address - Phone:706-653-5501
Mailing Address - Fax:706-653-5504
Practice Address - Street 1:1013 CENTRE BROOK CT
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4573
Practice Address - Country:US
Practice Address - Phone:706-653-5501
Practice Address - Fax:706-653-5504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000895213E00000X
GA009080213E00000X
GA000814213E00000X
AL236213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty