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NPI Code Detail

MEDICARE: FOOTHILLS SURGERY P.C.

MEDICARE: FOOTHILLS SURGERY P.C.
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
1174400000XSpecialist33951AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497958904
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOOTHILLS SURGERY P.C.
Provider Business Mailing Address
First Line : PO BOX 53587
Second Line :
City : PHOENIX
State : AZ
Zip : 85072-3587
Country : US
Telephone Number : 520-872-7634
Fax Number : 520-872-7969
Provider Business Practice Location Address
First Line : 4530 E. CAMP LOWELL ROAD
Second Line :
City : TUCSON
State : AZ
Zip : 85712
Country : US
Telephone Number : 520-320-1200
Fax Number : 520-320-1222
Authorized Official
Title or Position : BILLING MANAGER
Name : LISA M BCAUVAIS
Credential :
Telephone Number : 520-320-1200
Provider Enumeration Date : 06/11/2007
Last Update Date : 08/01/2008

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Directions to “FOOTHILLS SURGERY P.C. ” Practice Location

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