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Individual

ROBERT FLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
728 E WHITE MOUNTAIN BLVD, SUITE C, PINETOP, AZ 85935-7027
(928) 367-3701
(928) 367-0801
Mailing address
PO BOX 430D, PINETOP, AZ 85935-0416
(928) 367-3701
(928) 367-0801

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0105
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
700519
AZ
Enumeration date
10/07/2005
Last updated
07/08/2007
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