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General NPI Number Information
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NPI Number | 1689108649
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Entity Type | Organization
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Legal Business Name | ACACIA FOOT AND ANKLE SURGEONS, PLLC
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 9179 W THUNDERBIRD RD STE 101
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City | PEORIA
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State | AZ
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Zip | 85381-4912
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Country | US
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Telephone | 623-439-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 9179 W THUNDERBIRD RD STE 101
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City | PEORIA
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State | AZ
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Zip | 85381-4912
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Country | US
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Telephone | 623-439-2200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAVEH PANAHI
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Credential | DPM
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Telephone | 623-439-2200
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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 | 0793
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License Number State | AZ
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