Provider Demographics
NPI:1558897439
Name:AZ CHOICE FOOT AND ANKLE
Entity Type:Organization
Organization Name:AZ CHOICE FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ANDREAS
Authorized Official - Last Name:SUYKERBUYK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-632-5757
Mailing Address - Street 1:2730 S VAL VISTA DR
Mailing Address - Street 2:SUITE 136
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1675
Mailing Address - Country:US
Mailing Address - Phone:480-632-5757
Mailing Address - Fax:480-632-5765
Practice Address - Street 1:201 W GUADALUPE RD STE 318
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3335
Practice Address - Country:US
Practice Address - Phone:480-632-5757
Practice Address - Fax:480-632-5765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ728213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty