Podiatry Matrix LLC
Anesthesiology in Avondale, AZ. Organization (NPI-2).
NPI number1780162545
StatusActive
Last updated in NPPESAug 3, 2018
Details
- NPI
- 1780162545
- Entity type
- Organization (NPI-2)
- Legal business name
- Podiatry Matrix LLC
- Organization subpart
- No
- Enumeration date
- Aug 3, 2018
- Last updated
- Aug 3, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | – | – | Yes |
Practice location
13065 W McDowell Rd Ste C101Avondale, AZ 85392-6445
Phone 928-499-4519
Mailing address
2801 Centerville RoadPmb 690
Wilmington, DE 19808
Authorized official
Randall Brower
Manager
6235472800
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