Healthcare Provider Details

I. General information

NPI: 1588340129
Provider Name (Legal Business Name): BRANDON MITCHELL WINSKI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N 3RD ST STE 3020
PHOENIX AZ
85020-2425
US

IV. Provider business mailing address

21810 N CALLE ROYALE
SCOTTSDALE AZ
85255-4946
US

V. Phone/Fax

Practice location:
  • Phone: 480-939-3440
  • Fax: 480-939-3448
Mailing address:
  • Phone: 602-622-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD-001172
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD-001172
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: