Healthcare Provider Details
I. General information
NPI: 1053991620
Provider Name (Legal Business Name): SAGUARO FOOT & ANKLE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2021
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
740 N SAN MARCOS DR
APACHE JUNCTION AZ
85120-5518
US
IV. Provider business mailing address
740 N SAN MARCOS DR
APACHE JUNCTION AZ
85120-5518
US
V. Phone/Fax
- Phone: 480-597-1751
- Fax: 480-360-6591
- Phone: 480-597-1751
- Fax: 480-360-6591
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WESLEY
KREIG
LEWIS
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 480-710-3816