Provider Demographics
NPI:1477730315
Name:ACADEMY FOOT AND ANKLE CLINICS LTD
Entity type:Organization
Organization Name:ACADEMY FOOT AND ANKLE CLINICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHUKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:520-326-6766
Mailing Address - Street 1:5300 E ERICKSON DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2828
Mailing Address - Country:US
Mailing Address - Phone:520-326-6766
Mailing Address - Fax:520-323-6660
Practice Address - Street 1:5300 E ERICKSON DR
Practice Address - Street 2:SUITE 118
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2828
Practice Address - Country:US
Practice Address - Phone:520-326-6766
Practice Address - Fax:520-323-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00189213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ700288Medicaid
AZ480009265OtherRAILROAD MEDICARE
AZZDPM189BMedicare PIN
AZ480009265OtherRAILROAD MEDICARE
AZT41532Medicare UPIN