Provider Demographics
NPI:1326851361
Name:ALLEN FOOT AND ANKLE MEDICINE AND SURGERY PLC
Entity type:Organization
Organization Name:ALLEN FOOT AND ANKLE MEDICINE AND SURGERY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-633-7944
Mailing Address - Street 1:2919 S ELLSWORTH RD STE 124
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-2167
Mailing Address - Country:US
Mailing Address - Phone:480-633-7944
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE STE 107
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3317
Practice Address - Country:US
Practice Address - Phone:480-378-3395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEN FOOT AND ANKLE MEDICINE AND SURGERY PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty