Dr. Dale Fazio Foot Clinic

LBN: Dr. Dale Fazio Foot Clinic
Dr. Dale Fazio Foot Clinic is an health care organization with primary practice located at 1914 E 70Th St Suite D, Shreveport LA 71105-5312. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Dr. Dale Fazio Foot Clinic can be contacted via phone (318) 797-3470, or through Fazio, Dale C via phone (318) 797-3470.

Contact Information

Primary practice address
1914 E 70Th St Suite D Shreveport LA 71105-5312
Phone: (318) 797-3470
Fax: (318) 797-9956
Website:
Map and Directions
Authorized official contact:
Name: Fazio, Dale C Doctor of Medicine (MD)
Phone: (318) 797-3470

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PD009 Louisiana

Profile Details

NPI number 1265692859
LBN Legal business name Dr. Dale Fazio Foot Clinic
DBA Doing business as
Authorized official Fazio, Dale C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 17th, 2008
Last updated Jun 17th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265692859 NPPES
Louisiana MEDICAID 1318451

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