1598830713 NPI number — ARIZONA FOOT SPECIALISTS, LTD

Table of content: (NPI 1598830713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598830713 NPI number — ARIZONA FOOT SPECIALISTS, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA FOOT SPECIALISTS, LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598830713
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
697 W AJO WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85713-6047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-746-0186
Provider Business Mailing Address Fax Number:
520-746-0278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
697 W AJO WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85713-6047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-746-0186
Provider Business Practice Location Address Fax Number:
520-746-0278
Provider Enumeration Date:
11/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
QUINT
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PROVIDER
Authorized Official Telephone Number:
520-746-0186

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  0163 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213EP1101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213ES0131X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 154990XX . This is a "PREFERRED HEALTH NETWORK" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 4648739 . This is a "AETNA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 700311 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 700311 . This is a "HEALTHCHOICE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 700311 . This is a "AP/IPA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0065030 . This is a "SSA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1Z2388 . This is a "HEALTHNET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0065030 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 700311 . This is a "MERCYCARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 70031101 . This is a "AZ PHYSICIANS IPA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: DA3252 . This is a "MEDICARE RRB" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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