Healthcare Provider Details

I. General information

NPI: 1255321485
Provider Name (Legal Business Name): DAVID T TOUCHTON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 GRISWOLD ST
PORT HURON MI
48060-5918
US

IV. Provider business mailing address

603 GRISWOLD ST
PORT HURON MI
48060-5918
US

V. Phone/Fax

Practice location:
  • Phone: 810-987-7444
  • Fax: 810-982-7214
Mailing address:
  • Phone: 810-987-7444
  • Fax: 810-982-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number360102
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5901000539
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: