MARICOPA PODIATRY CORPORATION NPI 1649456229

NPI Information

NPI: 1649456229
Provider Name: MARICOPA PODIATRY CORPORATION
Classification: Podiatrist - 213ES0131X
Entity Type: Organization

Specialization: Foot Surgery

Address:
12361 W BOLA DR
SUITE 100
SURPRISE, AZ
ZIP 85378
Phone: (623) 214-3335
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MARICOPA PODIATRY CORPORATION is a foot surgery podiatrist in Surprise, AZ. MARICOPA PODIATRY CORPORATION NPI is 1649456229. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12361 W BOLA DR
SUITE 100
SURPRISE, AZ
ZIP 85378-021
Phone: (623) 214-3335
Fax: (623) 214-3956

The provider's authorized official is Tharesh Udupa .
The authorized official title is Owner and has the following contact phone number (623) 214-3335.

The enumeration date for this NPI number is 1/14/2008 and was last updated on 9/10/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	0599	ARIZONA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	842171	MEDICAID	ARIZONA
2	U88958	MEDICARE UPIN	ARIZONA
3	104693	MEDICARE OSCAR/CERTIFICATION	ARIZONA

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

NPI Synchronization or Removal

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