Healthcare Provider Details

I. General information

NPI: 1477152452
Provider Name (Legal Business Name): ARCADIA FOOT & ANKLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9421 W BELL RD STE 105
SUN CITY AZ
85351-1361
US

IV. Provider business mailing address

PO BOX 20490
MESA AZ
85277-0490
US

V. Phone/Fax

Practice location:
  • Phone: 623-977-5242
  • Fax: 623-977-5242
Mailing address:
  • Phone: 480-296-7642
  • Fax: 480-296-7643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARILYNN JEANNE PETERS
Title or Position: CREDENTIALER
Credential: CPC
Phone: 480-296-7642