AGAPE FOOT & ANKLE CLINIC LLC NPI 1952667305

NPI Information

NPI: 1952667305
Provider Name: AGAPE FOOT & ANKLE CLINIC, LLC
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
3693 WITTENBURG CT
DECATUR, GA
ZIP 30034
Phone: (404) 483-9761
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AGAPE FOOT & ANKLE CLINIC, LLC is a primary podiatric medicine podiatrist in Decatur, GA. AGAPE FOOT & ANKLE CLINIC, LLC NPI is 1952667305. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3693 WITTENBURG CT
DECATUR, GA
ZIP 30034-507
Phone: (404) 483-9761

The provider's authorized official is Corliss La-shunuette Austin-harris .
The authorized official title is President and has the following contact phone number (404) 483-9761.

The enumeration date for this NPI number is 4/10/2012 and was last updated on 4/19/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	POD000689	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U41116	MEDICARE UPIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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