Healthcare Provider Details

I. General information

NPI: 1265616643
Provider Name (Legal Business Name): ARTISAN PROSTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 N 32ND ST
PHOENIX AZ
85018-3339
US

IV. Provider business mailing address

1131 E HIGHLAND AVE
PHOENIX AZ
85014-3639
US

V. Phone/Fax

Practice location:
  • Phone: 602-667-7827
  • Fax: 602-667-7826
Mailing address:
  • Phone: 602-667-7827
  • Fax: 602-667-7826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN MITCHELL MCNAMEE
Title or Position: OWNER
Credential: CP
Phone: 602-667-7827