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General NPI Number Information
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NPI Number | 1699869149
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Entity Type | Organization
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Legal Business Name | AMERICAN FOOT CLINIC INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 5480 MAIN ST STE 105
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City | DEL CITY
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State | OK
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Zip | 73115-5517
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Country | US
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Telephone | 405-733-2783
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Fax | 405-741-2804
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Provider Business Mailing Address
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Address Line | 5480 MAIN ST STE 105
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City | DEL CITY
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State | OK
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Zip | 73115-5517
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Country | US
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Telephone | 405-733-2783
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Fax | 405-741-2804
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM DALE HALL IX
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Credential | DPM
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Telephone | 405-733-2783
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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 | 0126
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License Number State | OK
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