Organization
WESTERN ARIZONA FOOT & ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PATRICK WILSON DPM (OWNER)
(928) 680-4934
Entity
Organization
Contact information
Practice address
1980 MESQUITE AVE, SUITE 103, LAKE HAVASU CITY, AZ 86403-7713
(928) 680-4934
(928) 505-4416
Mailing address
1980 MESQUITE AVE, SUITE 103, LAKE HAVASU CITY, AZ 86403-7713
(928) 680-4934
(928) 505-4416
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0390
AZ
Other
Enumeration date
08/31/2007
Last updated
10/10/2007
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