Healthcare Provider Details

I. General information

NPI: 1780124974
Provider Name (Legal Business Name): ANKLE AND FOOT ASSOC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W FRANKLIN ST
SYLVESTER GA
31791-1900
US

IV. Provider business mailing address

501 W ONEIDA ST
WAYCROSS GA
31501-5337
US

V. Phone/Fax

Practice location:
  • Phone: 229-382-3338
  • Fax: 229-777-8269
Mailing address:
  • Phone: 912-283-6471
  • Fax: 912-283-3590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID P MURPHY
Title or Position: CEO
Credential: DPM
Phone: 912-283-6471