Provider Demographics
NPI:1417235748
Name:FIXINGFEET, PLLC
Entity Type:Organization
Organization Name:FIXINGFEET, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:623-584-5556
Mailing Address - Street 1:14823 W BELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7607
Mailing Address - Country:US
Mailing Address - Phone:623-584-5556
Mailing Address - Fax:623-584-0755
Practice Address - Street 1:14823 W BELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7607
Practice Address - Country:US
Practice Address - Phone:623-584-5556
Practice Address - Fax:623-584-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6622680001Medicare NSC
Z147612Medicare PIN