# FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316504574
- **Authorized official:** SETH CLARK DPM (OWNER)
- **Authorized official phone:** (623) 544-9090

## Contact information

- **Practice address:** 18301 N 79TH AVE STE F168, GLENDALE, AZ 85308-6045
- **Practice address phone:** (623) 544-9090
- **Practice address fax:** (623) 546-3704
- **Mailing address:** 18301 N 79TH AVE STE F168, GLENDALE, AZ 85308-6045
- **Mailing address phone:** (623) 544-9090
- **Mailing address fax:** (623) 546-3704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |

## Other

- **Enumeration date:** 05/23/2019
- **Last updated:** 12/31/2024