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Organization

PROVIDENCE FOOT & ANKLE CENTERS PC

Active
Parent organization
PROVIDENCE FOOT & ANKLE CENTERS, P.C.
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE FOOT & ANKLE CENTERS, P.C.
Authorized official
DR. ADRIENNE M. ATKINSON-SNEED D.P.M. (CEO)
(770) 745-4224
Entity
Organization

Contact information

Practice address
1110 MARSHALL RD, WELLNESS CENTER, GREENWOOD, SC 29646-4216
(866) 896-3338
(770) 790-4752
Mailing address
3886 PRINCETON LAKES WAY SW, SUITE 140A, ATLANTA, GA 30331-5511
(770) 745-4224
(770) 790-4752

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
213EP1101X
Primary Podiatric Medicine Podiatrist
213ER0200X
Radiology Podiatrist
213ES0000X
Sports Medicine Podiatrist
213ES0103X
Foot & Ankle Surgery Podiatrist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9277
MEDICARE GROUP PTAN FOR SC (PALMETTO GBA)
SC
01
DQ9090
MEDICARE RR (PALMETTO GBA) SC
SC
01
PENDING
DME (PALMETTO GBA NSC) GROUP PTAN
SC
Enumeration date
08/19/2008
Last updated
01/31/2013
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