Charles Connell, DPM | |
6104 E Brown Rd, Mesa, AZ 85205-4953 | |
(480) 699-7377 | |
Not Available |
Full Name | Charles Connell |
---|---|
Gender | Male |
Speciality | Podiatrist - Foot Surgery |
Location | 6104 E Brown Rd, Mesa, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992791313 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0131X | Podiatrist - Foot Surgery | 322 (Arizona) | Primary |
Provider Name | Kraemer Medical Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1326408782 PECOS PAC ID: 2769780295 Enrollment ID: O20160415001162 |
Mailing Address | Practice Location Address |
---|---|
Charles Connell, DPM 6104 E Brown Rd, Suite 102, Mesa, AZ 85205-4953 Ph: (480) 699-7377 | Charles Connell, DPM 6104 E Brown Rd, Mesa, AZ 85205-4953 Ph: (480) 699-7377 |
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