Provider Demographics
NPI:1518515980
Name:26 FOOT AND ANKLE MADISON LLC
Entity type:Organization
Organization Name:26 FOOT AND ANKLE MADISON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MENKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:706-257-0257
Mailing Address - Street 1:6350 LAKE OCONEE PKWY
Mailing Address - Street 2:STE110 PMB 30
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642
Mailing Address - Country:US
Mailing Address - Phone:706-257-0257
Mailing Address - Fax:706-257-0258
Practice Address - Street 1:2151 EATONTON RD STE I
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-5093
Practice Address - Country:US
Practice Address - Phone:706-257-0257
Practice Address - Fax:706-257-0258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:26 MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-29
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty