Provider Demographics
NPI:1174143770
Name:AFFILIATED FOOT AND ANKLE, P.C.
Entity type:Organization
Organization Name:AFFILIATED FOOT AND ANKLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILIATRAULT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:404-231-1227
Mailing Address - Street 1:3071 PEACHTREE INDUSTRIAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8607
Mailing Address - Country:US
Mailing Address - Phone:770-232-9778
Mailing Address - Fax:770-232-9776
Practice Address - Street 1:619 RANKIN ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2920
Practice Address - Country:US
Practice Address - Phone:404-231-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFILIATED FOOT & ANKLE P.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-23
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty