Healthcare Provider Details
I. General information
NPI: 1780855445
Provider Name (Legal Business Name): HOLLLANDER FOOT SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2008
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6558 E CARONDELET DR
TUCSON AZ
85710-2117
US
IV. Provider business mailing address
6558 E CARONDELET DR
TUCSON AZ
85710-2117
US
V. Phone/Fax
- Phone: 520-296-7456
- Fax: 520-296-6337
- Phone: 520-296-7456
- Fax: 520-296-6337
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | 0184 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
STEVEN
BARRY
HOLLANDER
Title or Position: PRESIDENT
Credential: DPM
Phone: 520-296-7456