Healthcare Provider Details

I. General information

NPI: 1336160548
Provider Name (Legal Business Name): SONORAN FOOT SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9767 N 91ST ST STE 101
SCOTTSDALE AZ
85258-5086
US

IV. Provider business mailing address

9767 N 91ST ST STE 101
SCOTTSDALE AZ
85258-5086
US

V. Phone/Fax

Practice location:
  • Phone: 480-629-5903
  • Fax: 480-629-8498
Mailing address:
  • Phone: 480-629-5903
  • Fax: 480-629-8498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0544
License Number StateAZ

VIII. Authorized Official

Name: DR. LEE DAVID RICHER
Title or Position: PODIATRIC SURGEON MEMBER MANAGER
Credential: D.P.M.
Phone: 480-629-5903