Individual
ANNIE JONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
(623) 933-4677
Mailing address
13660 N 94TH DR STE A3, STE A3, PEORIA, AZ 85381-4836
(623) 933-4645
(623) 933-4677
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0000
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0807
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25945
—
AZ
Enumeration date
07/12/2012
Last updated
11/24/2020
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