# WESTERN ARIZONA FOOT & ANKLE

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

## Provider details

- **NPI number:** 1356535405
- **Authorized official:** JAMES PATRICK WILSON DPM (OWNER)
- **Authorized official phone:** (928) 680-4934

## Contact information

- **Practice address:** 1980 MESQUITE AVE, SUITE 103, LAKE HAVASU CITY, AZ 86403-7713
- **Practice address phone:** (928) 680-4934
- **Practice address fax:** (928) 505-4416
- **Mailing address:** 1980 MESQUITE AVE, SUITE 103, LAKE HAVASU CITY, AZ 86403-7713
- **Mailing address phone:** (928) 680-4934
- **Mailing address fax:** (928) 505-4416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 0390 | AZ | Yes |

## Other

- **Enumeration date:** 08/31/2007
- **Last updated:** 10/10/2007