Provider Demographics
NPI:1427511872
Name:ARIZONA FOOT AND ANKLE MEDICAL CENTER PLLC
Entity type:Organization
Organization Name:ARIZONA FOOT AND ANKLE MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:DURFEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:801-691-3253
Mailing Address - Street 1:2302 E EGRET CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3804
Mailing Address - Country:US
Mailing Address - Phone:801-691-3253
Mailing Address - Fax:
Practice Address - Street 1:6170 S 51ST AVE STE 103
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6305
Practice Address - Country:US
Practice Address - Phone:801-691-3253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty