Provider Demographics
NPI:1114058260
Name:PHOENIX FOOT & ANKLE ASSOCIATES PC
Entity Type:Organization
Organization Name:PHOENIX FOOT & ANKLE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-251-3113
Mailing Address - Street 1:926 E MCDOWELL RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2503
Mailing Address - Country:US
Mailing Address - Phone:602-251-3113
Mailing Address - Fax:602-251-3114
Practice Address - Street 1:926 E MCDOWELL RD
Practice Address - Street 2:SUITE 211
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2503
Practice Address - Country:US
Practice Address - Phone:602-251-3113
Practice Address - Fax:602-251-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ480022566OtherMEDICARE RAILROAD
AZ79774Medicare PIN
AZ480022566OtherMEDICARE RAILROAD