Organization
PODIATRIC PHYSICIANS OF ARIZONA, INC.
Active
Other names
Arizona Institute of Footcare Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY KOCH (CFO)
(617) 562-7070
Entity
Organization
Contact information
Practice address
1620 S STAPLEY DR, 132, MESA, AZ 85204-6634
(480) 834-8804
(480) 464-8287
Mailing address
PO BOX 847818, DALLAS, TX 75284-7818
(480) 834-8804
(480) 464-8287
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500144
—
AZ
01
—
CD4380
PALMETTO GBA, RAILROAD MEDICARE
AZ
Enumeration date
04/24/2007
Last updated
03/06/2020
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