Individual provider · Type 1 NPI
Wade Allan Jespersen, DPM
Foot & Ankle Surgery Podiatrist · Queen Creek, AZ
NPI number
1174964654
Active
Practice location
19350 E Silver Creek Ln
Queen Creek, AZ 85142-9064
Fax (877) 666-4624
Mailing address
14050 N 83rd Ave, Ste 290
Peoria, AZ 85381-5650
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | SC006516 (PA) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 0843 (AZ) |
Foot & Ankle Surgery Podiatrist: Definition to come...
Another provider at this address
About NPI 1174964654
Wade Allan Jespersen, DPM's National Provider Identifier is 1174964654, issued on Jul 11, 2013. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Queen Creek, AZ. The record was last updated on May 9, 2019.