Healthcare Provider Details
I. General information
NPI: 1205887569
Provider Name (Legal Business Name): FAMILY FOOT & ANKLE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 S DOBSON RD STE E40
CHANDLER AZ
85224-5693
US
IV. Provider business mailing address
2680 S VAL VISTA DR STE 177
GILBERT AZ
85295-1674
US
V. Phone/Fax
- Phone: 480-909-3700
- Fax: 778-399-9728
- Phone: 480-909-3700
- Fax: 877-839-9972
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DARICK
HATHAWAY
FREESTONE
Title or Position: OWNER
Credential:
Phone: 480-909-3700