Healthcare Provider Details

I. General information

NPI: 1750569679
Provider Name (Legal Business Name): JAMES W. SHOFFER, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 W SACK DR SUITE 102
GLENDALE AZ
85308-7104
US

IV. Provider business mailing address

6525 W SACK DR SUITE 102
GLENDALE AZ
85308-7104
US

V. Phone/Fax

Practice location:
  • Phone: 623-825-9309
  • Fax: 623-566-3570
Mailing address:
  • Phone: 623-825-9309
  • Fax: 623-566-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES WILLIAM SHOFFER
Title or Position: OWNER/PRESIDENT
Credential: DPM
Phone: 623-825-9309