DR. DALE CARLTON FAZIO D.P.M.
NPI 1194723577
Podiatrist in Shreveport, LA

Active since July 11, 2005
1914 E 70TH ST, SUITE D, SHREVEPORT, LA 71105(318) 797-3470(318) 797-9956 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Dale Carlton Fazio D.p.m. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DALE CARLTON FAZIO D.P.M. (NPI 1194723577) is an individual podiatrist in Shreveport, Louisiana, licensed in Louisiana (PD009) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1194723577
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. DALE CARLTON FAZIOCredential: D.P.M.
Location Address1914 E 70TH ST, SUITE DShreveport, LA 71105-5312
Mailing Address1914 E 70th St, Suite DShreveport, LA 71105-5312 · (318) 797-3470 · Fax (318) 797-9956
Fax(318) 797-9956
Sole ProprietorNo
Enumeration DateJuly 11, 2005
Last NPPES UpdateJuly 8, 2007
NPI 1194723577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License Licensed in LA · PD009
Definition

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.

1914 E 70TH ST, Shreveport, LA 71105

Other Identifiers 3

Medicare UPINT19719LA
Medicare ID-Type Unspecified56342LA
Medicaid1318451LA

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Podiatrist
1914 E 70TH ST, SUITE D
SHREVEPORT, LA 71105
Dentist (Orthodontics and Dentofacial Orthopedics)
1914 E 70TH ST
SHREVEPORT, LA 71105

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194723577, enumerated as an "individual" on July 11, 2005.

The provider is located at 1914 E 70TH ST SUITE D SHREVEPORT, LA 71105 and the phone number is (318) 797-3470.

Podiatrist with taxonomy code 213E00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.