Provider Demographics
NPI:1093314072
Name:ARCADIA FOOT & ANKLE PC
Entity Type:Organization
Organization Name:ARCADIA FOOT & ANKLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYNN
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:480-231-5562
Mailing Address - Street 1:PO BOX 20490
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-0490
Mailing Address - Country:US
Mailing Address - Phone:480-296-7642
Mailing Address - Fax:480-296-7643
Practice Address - Street 1:10900 N SCOTTSDALE RD STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5222
Practice Address - Country:US
Practice Address - Phone:480-483-9000
Practice Address - Fax:480-483-1791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty