Basic Information
| Provider Information | |||||||||
| NPI: | 1922260579 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARQUEZ | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7620 E MCKELLIPS RD STE 4-225 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852574600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884954489 | ||||||||
| FaxNumber: | 4808658090 | ||||||||
| Practice Location | |||||||||
| Address1: | 7620 E MCKELLIPS RD STE 4-225 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852574600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884954489 | ||||||||
| FaxNumber: | 4808658090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2008 | ||||||||
| LastUpdateDate: | 02/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 2030 | NV | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213ES0103X | 0830 | AZ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 100749 | 05 | AZ | MEDICAID |