Providence Foot & Ankle Centers, Pc, Inc is a
Podiatrist - Foot & Ankle Surgery based in Hiram, Georgia. Providence Foot & Ankle Centers, Pc, Inc is licensed to practice in * (Not Available) (license number ) and their current practice location is
4109 Jimmy Lee Smith Pkwy, Suite C, Hiram, Georgia. It can be reached at their office (for appointments etc.) via phone at
(770) 745-4224.
NPI number for Providence Foot & Ankle Centers, Pc, Inc is 1083972376 and their current mailing address is 3886 Princeton Lakes Way Sw, Suite 140a, Atlanta, Georgia. Providence Foot & Ankle Centers, Pc, Inc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1083972376.
Healthcare Provider's Profile
| Full Name | Providence Foot & Ankle Centers, Pc, Inc |
|---|
| Type | Facility |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 4109 Jimmy Lee Smith Pkwy, Hiram, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1083972376
- Provider Enumeration Date: 04/25/2012
- Last Update Date: 04/25/2012
Medical Identifiers
Medical identifiers for Providence Foot & Ankle Centers, Pc, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083972376 | NPI | - | NPPES |
| 511G700902 | Other | GA | MEDICARE GROUP PTAN GEORGIA |
| DQ9092 | Other | GA | RR MEDICARE GROUP NUMBER GEORGIA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
| 213EP1101X | Podiatrist - Primary Podiatric Medicine | (* (Not Available)) | Secondary |
| 213ER0200X | Podiatrist - Radiology | (* (Not Available)) | Secondary |
| 213ES0000X | Podiatrist - Sports Medicine | (* (Not Available)) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Providence Foot & Ankle Centers, Pc, Inc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Providence Foot & Ankle Centers, Pc, Inc
3886 Princeton Lakes Way Sw, Suite 140a,
Atlanta, GA 30331-5511
Ph: (770) 745-4224 | Providence Foot & Ankle Centers, Pc, Inc
4109 Jimmy Lee Smith Pkwy, Suite C,
Hiram, GA 30141-2643
Ph: (770) 745-4224 |
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