Provider Demographics
NPI:1952362253
Name:GUNZY, TODD (DPM)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:GUNZY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80217
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-0217
Mailing Address - Country:US
Mailing Address - Phone:602-385-2115
Mailing Address - Fax:480-418-3323
Practice Address - Street 1:6116 E. ARBOR AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5235
Practice Address - Country:US
Practice Address - Phone:480-924-1552
Practice Address - Fax:480-830-8417
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0461213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ394859Medicaid
AZP00044071OtherMEDICARE RAILROAD
AZAZ019316OtherBCBS
AZ394859Medicaid
AZZWMBSTMedicare PIN
AZU19262Medicare UPIN
AZZ189665Medicare UPIN
AZ0744550001Medicare NSC