Healthcare Provider Details

I. General information

NPI: 1598945461
Provider Name (Legal Business Name): NORTH SCOTTSDALE PODIATRY GROUP ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9755 N 90TH ST STE C120
SCOTTSDALE AZ
85258-5046
US

IV. Provider business mailing address

9755 N 90TH ST STE C120
SCOTTSDALE AZ
85258-5046
US

V. Phone/Fax

Practice location:
  • Phone: 480-391-9193
  • Fax: 480-661-6202
Mailing address:
  • Phone: 480-391-9193
  • Fax: 480-661-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0112
License Number StateAZ

VIII. Authorized Official

Name: DR. LARRY ZONIS
Title or Position: OWNER
Credential: DPM
Phone: 480-391-9193