Healthcare Provider Details

I. General information

NPI: 1467644880
Provider Name (Legal Business Name): FOCUS FOOT & ANKLE CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5491 ROSWELL RD NE SUITE B
ATLANTA GA
30342-1911
US

IV. Provider business mailing address

5491 ROSWELL RD NE SUITE B
ATLANTA GA
30342-1911
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-6662
  • Fax:
Mailing address:
  • Phone: 404-252-6662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD000877
License Number StateGA

VIII. Authorized Official

Name: DR. JON DARRYL PITTS
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 404-252-6662