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General NPI Number Information
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NPI Number | 1326600313
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE SPECIALISTS OF NORTHEAST GEORGIA, LLC
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 09/17/2023
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Provider Practice Location Address
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Address Line | 2312 SPARTA WAY STE A
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City | BUFORD
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State | GA
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Zip | 30519-2001
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Country | US
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Telephone | 678-619-1270
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Fax | 678-619-1272
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Provider Business Mailing Address
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Address Line | 2312 SPARTA WAY STE A
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City | BUFORD
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State | GA
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Zip | 30519-2001
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Country | US
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Telephone | 678-619-1270
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. ZACHARY GEORGE FARLEY
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Credential | DPM
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Telephone | 678-619-1270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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