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Blake Wallace, DPM — NPI 1083216949, Phoenix, AZ | NPI Central

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Blake Wallace, DPM

NPI 1083216949 · Foot & Ankle Surgery Podiatrist · Phoenix, AZ

Provider details

NPI number: 1083216949
Entity type: Individual
Primary specialty: Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
Credential: DPM
Sex: Male
Sole proprietor: Yes
License: POD-001117 (AZ)

Specialties & taxonomies

Foot & Ankle Surgery PodiatristPrimary213ES0103XLicense POD-001117 (AZ)
Podiatric Medicine & Surgery Service Providers

Practice location

15601 N 28th Ave Ste 102

Phoenix, AZ 85053-4061

Phone: (480) 844-8218

Approximate (ZIP-level) locationGet directions

More AZ providers

Mailing address

Po Box 32611

Belfast, ME 04915-0219

Additional practice locations (2)

3100 Telegraph Ave
Oakland, CA 94609-3239
Phone: (800) 607-6377
8414 Naab Rd Ste 215
Indianapolis, IN 46260-1972
Phone: (317) 338-7510

Registry dates

Enumerated: 2020-11-14
Last updated: 2024-07-29
Certified: 2024-07-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.