Individual
NATHANIEL A PTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5750 E HIGHWAY 90 STE 200, SIERRA VISTA, AZ 85635-9113
(520) 263-3761
(520) 263-3779
Mailing address
5750 E HIGHWAY 90 STE 200, SIERRA VISTA, AZ 85635-9113
(520) 263-3761
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
12366058-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001108
AZ
Other
Enumeration date
07/05/2019
Last updated
06/26/2025
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