Healthcare Provider Details

I. General information

NPI: 1740324037
Provider Name (Legal Business Name): AMERICAN FOOT & LEG SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 FOREST PKWY SUITE 101
FOREST PARK GA
30297
US

IV. Provider business mailing address

425 FOREST PKWY SUITE 101
FOREST PARK GA
30297-2185
US

V. Phone/Fax

Practice location:
  • Phone: 404-363-9944
  • Fax: 404-363-9951
Mailing address:
  • Phone: 404-363-9944
  • Fax: 404-363-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD000808
License Number StateGA

VIII. Authorized Official

Name: SHERRI L BARRON
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 404-363-9944