Healthcare Provider Details

I. General information

NPI: 1124300561
Provider Name (Legal Business Name): HUNCHAK HOLDINGS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33777 N SCOTTSDALE RD STE 101
SCOTTSDALE AZ
85266-1569
US

IV. Provider business mailing address

33777 N SCOTTSDALE RD STE 101
SCOTTSDALE AZ
85266-1569
US

V. Phone/Fax

Practice location:
  • Phone: 480-252-2279
  • Fax: 602-513-7309
Mailing address:
  • Phone: 480-252-2279
  • Fax: 602-513-7309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0730
License Number StateAZ

VIII. Authorized Official

Name: DR. DEREK HUNCHAK
Title or Position: CEO/PRESIDENT
Credential: D.P.M.
Phone: 480-252-2279