Healthcare Provider Details

I. General information

NPI: 1598716706
Provider Name (Legal Business Name): WILLIAM D FISHCO DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41818 N VENTURE DR SUITE 110
ANTHEM AZ
85086-3188
US

IV. Provider business mailing address

41818 N VENTURE DR SUITE 110
ANTHEM AZ
85086-3188
US

V. Phone/Fax

Practice location:
  • Phone: 623-551-5000
  • Fax: 800-530-9132
Mailing address:
  • Phone: 623-551-5000
  • Fax: 800-530-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM D FISHCO
Title or Position: PROVIDER
Credential: DPM
Phone: 602-993-2700