Healthcare Provider Details

I. General information

NPI: 1134462591
Provider Name (Legal Business Name): ANKLE AND FOOT CENTERS OF GEORGIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 WINDY HILL RD SE
SMYRNA GA
30080-1903
US

IV. Provider business mailing address

1975 HIGHWAY 54 W SUITE 205
FAYETTEVILLE GA
30214-4794
US

V. Phone/Fax

Practice location:
  • Phone: 770-434-7078
  • Fax: 770-434-0189
Mailing address:
  • Phone: 678-561-9000
  • Fax: 678-854-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH D GIOVINCO
Title or Position: MANAGING PARTNER
Credential: DPM
Phone: 678-561-9000