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General NPI Number Information
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NPI Number | 1609366533
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Entity Type | Organization
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Legal Business Name | PODIATRIC PHYSICIANS OF ARIZONA, INC.
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 11851 N 51ST AVE STE D120
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City | GLENDALE
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State | AZ
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Zip | 85304-2839
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Country | US
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Telephone | 480-505-0755
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Fax | 480-505-0750
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Provider Business Mailing Address
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Address Line | PO BOX 847818
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City | DALLAS
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State | TX
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Zip | 75284-7818
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Country | US
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Telephone | 480-834-8804
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KAREN H ABBOTT
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Credential |
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Telephone | 615-467-1246
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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 |
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License Number State |
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