Healthcare Provider Details

I. General information

NPI: 1629535273
Provider Name (Legal Business Name): SAGUARO FOOT AND ANKLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2066 W APACHE TRL STE 110
APACHE JUNCTION AZ
85120-3733
US

IV. Provider business mailing address

2066 W APACHE TRL STE 110
APACHE JUNCTION AZ
85120-3733
US

V. Phone/Fax

Practice location:
  • Phone: 480-597-1751
  • Fax: 844-863-5016
Mailing address:
  • Phone: 480-597-1751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: WESLEY KREIG LEWIS
Title or Position: PHYSICIAN
Credential: DPM
Phone: 480-710-3816