DR. DALE CARLTON FAZIO D.P.M. NPI 1194723577

NPI Information

DR. Dale Carlton Fazio, D.P.M. is a podiatrist in Shreveport, LA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DR. Dale Carlton Fazio, D.P.M. NPI is 1194723577. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1914 E 70TH ST
SUITE D
SHREVEPORT, LA
ZIP 71105-312
Phone: (318) 797-3470
Fax: (318) 797-9956

The enumeration date for this NPI number is 7/11/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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