Provider Demographics
NPI:1700327202
Name:ARIZONA FOOT AND ANKLE PHYSICIANS P L L C
Entity Type:Organization
Organization Name:ARIZONA FOOT AND ANKLE PHYSICIANS P L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:AIDA
Authorized Official - Last Name:KOSAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-433-3265
Mailing Address - Street 1:11390 E VIA LINDA
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4075
Mailing Address - Country:US
Mailing Address - Phone:480-247-8443
Mailing Address - Fax:480-292-9381
Practice Address - Street 1:11390 E VIA LINDA STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4075
Practice Address - Country:US
Practice Address - Phone:480-247-8443
Practice Address - Fax:480-292-9381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0798213EP1101X, 213ES0000X, 213ES0103X, 261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty