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General NPI Number Information
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NPI Number | 1679603724
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Entity Type | Organization
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Legal Business Name | FOOT ANKLE SPECIALTY CENTERS, LLC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 4915 E BASELINE ROAD BLDG 8, SUITE 121
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City | GILBERT
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State | AZ
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Zip | 85234-2965
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Country | US
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Telephone | 480-812-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 4915 E BASELINE ROAD BLDG 8, SUITE 121
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City | GILBERT
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State | AZ
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Zip | 85234-2965
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Country | US
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Telephone | 480-812-3668
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Fax | 480-782-1290
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CONSTANTINE SAFIS
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Credential |
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Telephone | 480-812-3668
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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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