Provider Demographics
NPI:1104901925
Name:WINDY HILL PODIATRY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:WINDY HILL PODIATRY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROTHSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:770-952-5300
Mailing Address - Street 1:2520 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8633
Mailing Address - Country:US
Mailing Address - Phone:770-952-5300
Mailing Address - Fax:770-952-4833
Practice Address - Street 1:2520 WINDY HILL RD SE
Practice Address - Street 2:SUITE 105
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8633
Practice Address - Country:US
Practice Address - Phone:770-952-5300
Practice Address - Fax:770-952-4833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK2497Medicare PIN
GA0805790001Medicare NSC
GAGRP4532Medicare ID - Type Unspecified