Healthcare Provider Details

I. General information

NPI: 1104857143
Provider Name (Legal Business Name): FOOTHILLS NEUROLOGY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 E MUIRWOOD DR STE 111
PHOENIX AZ
85048-7693
US

IV. Provider business mailing address

4505 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7688
US

V. Phone/Fax

Practice location:
  • Phone: 480-961-2365
  • Fax: 480-961-2382
Mailing address:
  • Phone: 480-961-2365
  • Fax: 480-961-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDY STRAUSS
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 480-963-2365