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Individual

HAYDEN VERL POULSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3200 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-2255
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
11154868-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD-000953
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002897
AZ
Enumeration date
02/25/2019
Last updated
08/08/2025
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