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General NPI Number Information
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NPI Number | 1124300561
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Entity Type | Organization
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Legal Business Name | HUNCHAK HOLDINGS PLLC
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 33777 N SCOTTSDALE RD STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-1569
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Country | US
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Telephone | 480-252-2279
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Fax | 602-513-7309
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Provider Business Mailing Address
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Address Line | 33777 N SCOTTSDALE RD STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-1569
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Country | US
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Telephone | 480-252-2279
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Fax | 602-513-7309
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. DEREK HUNCHAK
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Credential | D.P.M.
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Telephone | 480-252-2279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0730
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License Number State | AZ
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