Healthcare Provider Details

I. General information

NPI: 1598688772
Provider Name (Legal Business Name): DAVID J TERRY DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 CROSSINGS DR
PRESCOTT AZ
86305-7150
US

IV. Provider business mailing address

3605 CROSSINGS DR STE A
PRESCOTT AZ
86305-7150
US

V. Phone/Fax

Practice location:
  • Phone: 928-499-5134
  • Fax:
Mailing address:
  • Phone: 928-499-5134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DAVID J TERRY
Title or Position: PROVIDER
Credential: DPM
Phone: 928-499-5134