Provider Demographics
NPI:1689863664
Name:GRANONE, JULIA FRANCES (DPM)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:FRANCES
Last Name:GRANONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1151 S LA CANADA DR STE 213
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-1943
Mailing Address - Country:US
Mailing Address - Phone:520-625-1604
Mailing Address - Fax:520-625-6011
Practice Address - Street 1:1151 S LA CANADA DR STE 213
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-1943
Practice Address - Country:US
Practice Address - Phone:520-625-1604
Practice Address - Fax:520-625-6011
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2013-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ167213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT41669Medicare UPIN