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Providence Foot & Ankle Centers, Pc, Inc
Foot & Ankle Surgery Podiatrist in Hiram, Georgia
NPI 1083972376

Providence Foot & Ankle Centers, Pc, Inc is a Foot & Ankle Surgery Podiatrist based in Atlanta, GA and is specialized in Foot & Ankle Surgery. Providence Foot & Ankle Centers, Pc, Inc practices in Hiram, GA. The NPI Number for Providence Foot & Ankle Centers, Pc, Inc is 1083972376 and holds a License No. (Georgia).

The current practice location address for Providence Foot & Ankle Centers, Pc, Inc is 4109 Jimmy Lee Smith Pkwy, Hiram, GA and can be reached out via phone at 770-745-4224 and via fax at 770-745-4228.

Location: 4109 Jimmy Lee Smith Pkwy, Hiram, GA, 30331-5511
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083972376
Provider Name
Providence Foot & Ankle Centers, Pc, Inc
Credential
Provider Entity Type
Organization
Address
4109 Jimmy Lee Smith Pkwy, Hiram, GA, 30331-5511
Phone Number
770-745-4224
Fax Number
770-745-4228
Provider Enumeration Date
04/25/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
511G700902 01 GA MEDICARE GROUP PTAN GEORGIA
DQ9092 01 GA RR MEDICARE GROUP NUMBER GEORGIA
institution
Provider Business Practice Location Address Details
Address
4109 Jimmy Lee Smith Pkwy
City
Hiram
State
Georgia
Zip
30141-2643
Phone Number
770-745-4224
Fax Number
770-745-4228
person
Provider Business Mailing Address Details
Address
4109 Jimmy Lee Smith Pkwy
City
Hiram
State
Georgia
Zip
30141-2643
Phone Number
770-745-4224
Fax Number
770-745-4228
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
()
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
213EP1101X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Radiology
Taxonomy
213ER0200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Sports Medicine
Taxonomy
213ES0000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
()
Definition
Definition to come...
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