Healthcare Provider Details
I. General information
NPI: 1275766354
Provider Name (Legal Business Name): AFFORDABLE FOOTCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2009
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13629 W CAMINO DEL SOL SUITE 150
SUN CITY WEST AZ
85375-1405
US
IV. Provider business mailing address
13629 W CAMINO DEL SOL SUITE 150
SUN CITY WEST AZ
85375-1405
US
V. Phone/Fax
- Phone: 623-584-6500
- Fax: 623-584-6335
- Phone: 623-584-6500
- Fax: 623-584-6335
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 0216 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
BRAD
LEE
HAYMAN
Title or Position: OWNER
Credential: D.P.M.
Phone: 623-584-6500