Healthcare Provider Details

I. General information

NPI: 1497786750
Provider Name (Legal Business Name): ERIC H ESPENSEN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N CAMPBELL AVE ROOM 4402
TUCSON AZ
85724-5872
US

IV. Provider business mailing address

10367 E SIXTO MOLINA LN
TUCSON AZ
85747-5852
US

V. Phone/Fax

Practice location:
  • Phone: 520-626-1349
  • Fax: 520-626-8140
Mailing address:
  • Phone: 818-445-3123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: