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EAST VALLEY FOOTCARE PLLC NPI 1184737546


NPI Information

NPI: 1184737546
Provider Name: EAST VALLEY FOOTCARE PLLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
6104 E BROWN RD
SUITE 102
MESA, AZ
ZIP 85205
Phone: (480) 357-4400
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EAST VALLEY FOOTCARE PLLC is a podiatrist in Mesa, AZ. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. EAST VALLEY FOOTCARE PLLC NPI is 1184737546. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6104 E BROWN RD
SUITE 102
MESA, AZ
ZIP 85205-953
Phone: (480) 357-4400
Fax: (480) 807-0800

The provider's authorized official is Charles Connell .
The authorized official title is President and has the following contact phone number (480) 357-4400.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 4/23/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatrist322ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1480032937OTHERARIZONARAILROAD MEDICARE
24416650001MEDICARE NSCARIZONA
3480032936OTHERARIZONARR MEDICARE
4Z68001MEDICARE PINARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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