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General NPI Number Information
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NPI Number | 1700093044
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Entity Type | Organization
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Legal Business Name | ASSOCIATED FOOT AND ANKLE AMBULATORY SURGERY CENTER INC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 1854 FORSYTH ST SUITE 3
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City | MACON
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State | GA
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Zip | 31201-1169
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Country | US
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Telephone | 478-745-2600
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Fax | 478-742-5657
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Provider Business Mailing Address
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Address Line | 1854 FORSYTH ST SUITE 3
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City | MACON
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State | GA
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Zip | 31201-1169
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Country | US
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Telephone | 478-745-2600
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Fax | 478-742-5657
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. PAUL G SMAHA II
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Credential | DPM
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Telephone | 478-745-2600
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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 | 011-175
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License Number State | GA
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