Healthcare Provider Details

I. General information

NPI: 1083674857
Provider Name (Legal Business Name): RAYMOND R BOTTE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BELL ROCK PLZ STE C
SEDONA AZ
86351-9066
US

IV. Provider business mailing address

3010 E KERRY LN
PHOENIX AZ
85050-2501
US

V. Phone/Fax

Practice location:
  • Phone: 602-677-2688
  • Fax:
Mailing address:
  • Phone: 602-677-2688
  • Fax: 201-829-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number245
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number260
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: