Provider Demographics
NPI:1700068228
Name:T & L FOOT & ANKLE SURGEONS
Entity Type:Organization
Organization Name:T & L FOOT & ANKLE SURGEONS
Other - Org Name:PREMIER FOOT & ANKLE SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAWNYA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:PFITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:623-547-2800
Mailing Address - Street 1:13065 W MCDOWELL RD
Mailing Address - Street 2:SUITE A 103
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6439
Mailing Address - Country:US
Mailing Address - Phone:623-547-2800
Mailing Address - Fax:623-547-3083
Practice Address - Street 1:13065 W MCDOWELL RD
Practice Address - Street 2:SUITE A 103
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6439
Practice Address - Country:US
Practice Address - Phone:623-547-2800
Practice Address - Fax:623-547-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0580213ES0103X
AZ0607213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ79806Medicare PIN