Organization
FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH CLARK (AUTHORIZED OFFICIAL)
(623) 544-9090
Entity
Organization
Contact information
Practice address
14973 W BELL RD STE 110, SURPRISE, AZ 85374-3236
(623) 544-9090
(623) 546-3704
Mailing address
18301 N 79TH AVE STE F168, GLENDALE, AZ 85308-6045
(623) 544-9090
(623) 546-3704
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
08/04/2020
Last updated
04/08/2024
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