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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: August 16, 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
Phone(318) 797-3470
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
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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.

DR. BENJAMIN COLE FOSTER D.D.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
1914 E 70TH ST
SHREVEPORT, LA 71105
Caddo Parish (318) 797-8833
DR. DALE FAZIO FOOT CLINIC
Podiatrist
1914 E 70TH ST, SUITE D
SHREVEPORT, LA 71105
Caddo Parish (318) 797-3470

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dale Fazio's NPI number?

The NPI number for Dale Fazio is 1194723577. It was assigned to this individual provider in the NPPES registry on July 11, 2005.

Where is Dale Fazio located?

Dale Fazio practices at 1914 E 70th St Suite D, Shreveport, LA 71105. The listed phone number is (318) 797-3470.

What is Dale Fazio's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

When was this NPI record last updated?

The NPPES record for Dale Fazio was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.