Healthcare Provider Details

I. General information

NPI: 1922367994
Provider Name (Legal Business Name): FORSYTH FOOT & ANKLE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MARY ALICE PARK RD STE 201
CUMMING GA
30040-2682
US

IV. Provider business mailing address

102 MARY ALICE PARK RD STE 201
CUMMING GA
30040-2682
US

V. Phone/Fax

Practice location:
  • Phone: 678-262-4040
  • Fax: 678-262-4060
Mailing address:
  • Phone: 678-262-4040
  • Fax: 678-262-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number StateGA

VIII. Authorized Official

Name: MICHAEL C. MCGLAMRY
Title or Position: OWNER
Credential: DPM
Phone: 678-262-4040