Provider Demographics
NPI:1114812195
Name:BUCKHEAD PODIATRY ASSOCIATES LLC
Entity type:Organization
Organization Name:BUCKHEAD PODIATRY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:770-905-5393
Mailing Address - Street 1:3193 HOWELL MILL RD NW STE 326
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2100
Mailing Address - Country:US
Mailing Address - Phone:404-355-4522
Mailing Address - Fax:404-355-4512
Practice Address - Street 1:3193 HOWELL MILL RD NW STE 326
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2100
Practice Address - Country:US
Practice Address - Phone:404-355-4522
Practice Address - Fax:404-355-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty