Healthcare Provider Details

I. General information

NPI: 1386614220
Provider Name (Legal Business Name): DENNIS JOHN FOOTE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAHC SCHOFIELD BARRACKS PODIATRY CLINIC
SCHOFIELD BARRACKS HI
96857
US

IV. Provider business mailing address

USAHC SCHOFIELD BARRACKS PODIATRY CLINIC
SCHOFIELD BARRACKS HI
96857
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8629
  • Fax: 808-433-8632
Mailing address:
  • Phone: 808-433-8629
  • Fax: 808-433-8632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36-00-2152-F
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: