Provider Demographics
NPI:1710981790
Name:EROTAS, JOHN T (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:EROTAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10900 N SCOTTSDALE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5222
Mailing Address - Country:US
Mailing Address - Phone:480-483-9000
Mailing Address - Fax:480-483-1791
Practice Address - Street 1:10900 N SCOTTSDALE RD
Practice Address - Street 2:STE 101
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
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ228213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ480017201OtherMEDICARE RAILROAD
Z48WCKGG02Medicare ID - Type Unspecified
T41587Medicare UPIN