Healthcare Provider Details

I. General information

NPI: 1033571328
Provider Name (Legal Business Name): CHASE A CORLEY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6104 E BROWN RD STE 101
MESA AZ
85205-4953
US

IV. Provider business mailing address

6104 E BROWN RD STE 101
MESA AZ
85205-4953
US

V. Phone/Fax

Practice location:
  • Phone: 480-219-4100
  • Fax: 877-258-1138
Mailing address:
  • Phone: 480-219-4100
  • Fax: 877-258-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD000931
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: