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General NPI Number Information
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NPI Number | 1073886685
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Entity Type | Organization
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Legal Business Name | FEITZ FOOT CLINIC PA
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 3025 6TH ST
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City | MARIANNA
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State | FL
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Zip | 32446-1930
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Country | US
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Telephone | 850-784-9787
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Fax | 850-784-9619
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Provider Business Mailing Address
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Address Line | 2424 FRANKFORD AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-2239
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Country | US
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Telephone | 850-784-9787
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Fax | 850-784-9619
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL EUGENE FEITZ
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Credential | PODIATRY
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Telephone | 850-784-9787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO-2094
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO-2094
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO-2094
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License Number State | FL
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