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General NPI Number Information
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NPI Number | 1578537247
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Entity Type | Organization
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Legal Business Name | WINDY HILL PODIATRY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 2520 WINDY HILL RD SE SUIT 105
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City | MARIETTA
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State | GA
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Zip | 30067-8664
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Country | US
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Telephone | 770-952-0868
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Fax | 770-952-5300
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Provider Business Mailing Address
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Address Line | 1975 HIGHWAY 54 W STE 205
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4794
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Country | US
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Telephone | 678-902-0457
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Fax | 770-952-5300
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Authorized Official
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Title or Position | PHYSICAN/OWNER
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Name | DR. KETAN PATEL
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Credential | D.P.M.
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Telephone | 678-561-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 033-067
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License Number State | GA
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