Healthcare Provider Details

I. General information

NPI: 1245288950
Provider Name (Legal Business Name): JAMES A LONGTON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 10/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 W THUNDERBIRD RD
GLENDALE AZ
85306-4622
US

IV. Provider business mailing address

3217 E SHEA BLVD # 503
PHOENIX AZ
85028-3340
US

V. Phone/Fax

Practice location:
  • Phone: 602-865-2230
  • Fax: 866-598-4832
Mailing address:
  • Phone: 480-212-2959
  • Fax: 866-598-4832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0639
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: