DR. Dale Carlton Fazio, D.P.M.

NPI #1194723577 in Shreveport, Louisiana

Provider Information

NPI Number: 1194723577
Entity Type: Individual
Name: DR. Dale Carlton Fazio, D.P.M.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Podiatrist
Credential: D.P.M.
Enumeration Date: Jul 11, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1914 E 70TH ST
Address 2: SUITE D
City: Shreveport
State: Louisiana
ZIP Code: 71105-5312
Phone: (318) 797-3470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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