Healthcare Provider Details

I. General information

NPI: 1114058260
Provider Name (Legal Business Name): PHOENIX FOOT & ANKLE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 E MCDOWELL RD SUITE 211
PHOENIX AZ
85006-2503
US

IV. Provider business mailing address

926 E MCDOWELL RD SUITE 211
PHOENIX AZ
85006-2503
US

V. Phone/Fax

Practice location:
  • Phone: 602-251-3113
  • Fax: 602-251-3114
Mailing address:
  • Phone: 602-251-3113
  • Fax: 602-251-3114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ADRIENNE HARLAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 602-251-3113