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General NPI Number Information
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NPI Number | 1639398183
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Entity Type | Organization
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Legal Business Name | DESERT FOOT & ANKLE P C
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1520 S DOBSON RD SUITE 312
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City | MESA
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State | AZ
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Zip | 85202-4700
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Country | US
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Telephone | 480-844-8218
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Fax | 480-844-9950
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Provider Business Mailing Address
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Address Line | PO BOX 32611
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City | BELFAST
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State | ME
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Zip | 04915-0219
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Country | US
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Telephone | 480-844-8218
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Fax | 480-844-9950
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Authorized Official
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Title or Position | RCMO
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Name | ALEXANDER REYZELMAN
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Credential | DPM
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Telephone | 415-292-0638
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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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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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