Healthcare Provider Details

I. General information

NPI: 1780010652
Provider Name (Legal Business Name): DAVID W WAITE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14575 N 83RD PL
SCOTTSDALE AZ
85260-2926
US

IV. Provider business mailing address

4644 E ROY ROGERS RD
CAVE CREEK AZ
85331-3272
US

V. Phone/Fax

Practice location:
  • Phone: 620-791-8402
  • Fax:
Mailing address:
  • Phone: 620-791-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number11-04706
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberLPT-13746
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: