Provider Demographics
NPI:1750388237
Name:WEISKOPF, STEVEN A (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:WEISKOPF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 CIRCLE 75 PKWY.
Mailing Address - Street 2:STE. 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3084
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:1198 BUCKHEAD XING
Practice Address - Street 2:SUITE D
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-4257
Practice Address - Country:US
Practice Address - Phone:770-928-9263
Practice Address - Fax:770-874-5860
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000889213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00937241AMedicaid
GAU85946Medicare UPIN
GA1103400010Medicare NSC
GA480032370Medicare PIN
GA48SCCHBMedicare PIN