MEDICARE: DR. JAMES WILLIAM SHOFFER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	0382	AZ

General Provider Information

NPI Number	:	1194720946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES WILLIAM SHOFFER DPM

Provider Business Mailing Address
First Line	:	7200 W BELL RD
Second Line	:	E101
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8529
Country	:	US
Telephone Number	:	623-825-9309
Fax Number	:	623-505-9822

Provider Business Practice Location Address
First Line	:	7200 W BELL RD
Second Line	:	E101
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8529
Country	:	US
Telephone Number	:	623-825-9309
Fax Number	:	623-505-9822

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/28/2014

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