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Organization

KEITH BANGART DPM PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH BANGART DPM (PRESIDENT)
(623) 974-0522
Entity
Organization

Contact information

Practice address
13660 N 94TH DR STE F1, PEORIA, AZ 85381-4232
(623) 974-0522
(623) 933-5787
Mailing address
13660 N 94TH DR STE F1, PEORIA, AZ 85381-4232
(623) 974-0522
(623) 933-5787

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0724
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0724
AZ LICENSE
AZ
Enumeration date
04/08/2011
Last updated
03/07/2023
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