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General NPI Number Information
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NPI Number | 1992668222
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 4869 WILLIAMS DR STE 105
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City | GEORGETOWN
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State | TX
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Zip | 78633-2432
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Country | US
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Telephone | 512-759-8220
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Fax | 844-498-2130
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Provider Business Mailing Address
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Address Line | 7942 W BELL RD STE C5-424
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City | GLENDALE
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State | AZ
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Zip | 85308-8708
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Country | US
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Telephone | 512-759-8220
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Fax | 844-498-2130
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Authorized Official
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Title or Position | CEO
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Name | SEAN BROWN
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Credential |
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Telephone | 512-759-8220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 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 #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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