Provider Demographics
NPI:1780855445
Name:HOLLLANDER FOOT SPECIALISTS PC
Entity Type:Organization
Organization Name:HOLLLANDER FOOT SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:HOLLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:520-296-7456
Mailing Address - Street 1:6558 E CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2117
Mailing Address - Country:US
Mailing Address - Phone:520-296-7456
Mailing Address - Fax:520-296-6337
Practice Address - Street 1:6558 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2117
Practice Address - Country:US
Practice Address - Phone:520-296-7456
Practice Address - Fax:520-296-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0184213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ700460Medicaid
AZ7OO460Medicaid
AZAZ0065670OtherBLUE CROSS BLUE SHIELD
AZAZ0065740OtherBLUE CROSS BLUE SHIELD
AZAZ0065740OtherBLUE CROSS BLUE SHIELD
AZ700460Medicaid
AZ48WCHPQ01Medicare PIN
AZ48WCHPQ02Medicare PIN