Provider Demographics
NPI:1053991620
Name:SAGUARO FOOT & ANKLE CLINIC PLLC
Entity type:Organization
Organization Name:SAGUARO FOOT & ANKLE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:KREIG
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-597-1751
Mailing Address - Street 1:740 N SAN MARCOS DR
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-5518
Mailing Address - Country:US
Mailing Address - Phone:480-597-1751
Mailing Address - Fax:480-360-6591
Practice Address - Street 1:740 N SAN MARCOS DR
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-5518
Practice Address - Country:US
Practice Address - Phone:480-597-1751
Practice Address - Fax:480-360-6591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty