Healthcare Provider Details

I. General information

NPI: 1851706451
Provider Name (Legal Business Name): ATLANTIS FOOT AND ANKLE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 E CONFERENCE DR
TEMPE AZ
85284-2604
US

IV. Provider business mailing address

PO BOX 14367
SCOTTSDALE AZ
85267-4367
US

V. Phone/Fax

Practice location:
  • Phone: 602-432-8813
  • Fax: 888-979-8104
Mailing address:
  • Phone: 602-432-8813
  • Fax: 888-979-8104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: DR. DAVID K TOWNS
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 602-432-8813