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General NPI Number Information
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NPI Number | 1649631037
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE INSTITUTE OF GEORGIA
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 1815 HIGHWAY 138 SE # SR SUITE 600
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City | CONYERS
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State | GA
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Zip | 30013-2079
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Country | US
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Telephone | 770-922-8922
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Fax | 770-922-8956
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Provider Business Mailing Address
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Address Line | 1775 PARKER RD SE STE C240
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City | CONYERS
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State | GA
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Zip | 30094-6679
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Country | US
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Telephone | 770-922-8922
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Fax | 770-922-8922
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADRIANNE J ROSS
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Credential | D.P.M
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Telephone | 770-922-8922
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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 | POD001201
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License Number State | GA
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