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General NPI Number Information
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NPI Number | 1952596991
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Entity Type | Organization
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Legal Business Name | ANTHONY ROSALES, DPM, PC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 421 N HUMPHREYS ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4531
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Country | US
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Telephone | 928-774-4825
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Fax | 888-464-1135
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Provider Business Mailing Address
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Address Line | 421 N HUMPHREYS ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4531
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Country | US
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Telephone | 928-774-4825
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Fax | 888-464-1135
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY ROSALES
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Credential | DPM
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Telephone | 928-774-4825
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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 | 0608
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License Number State | AZ
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