Individual
DR. MARK ANTHONY ROSALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
421 N HUMPHREYS ST, FLAGSTAFF, AZ 86001-4531
(928) 774-9325
(888) 464-1135
Mailing address
421 N HUMPHREYS ST, FLAGSTAFF, AZ 86001-4531
(928) 774-9325
(888) 464-1135
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0608
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861453953
NPI
—
05
—
934225-001
—
AZ
01
—
AZ0195640
BC/BS ID#
AZ
01
—
Z118265
PTAN
—
Enumeration date
03/29/2006
Last updated
02/11/2016
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