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General NPI Number Information
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NPI Number | 1922152024
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Entity Type | Organization
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Legal Business Name | BLUE MOUNTAIN FOOT SPECIALISTS INC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 714 SW DORION AVE
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City | PENDLETON
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State | OR
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Zip | 97801-2086
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Country | US
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Telephone | 541-276-2372
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Fax |
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Provider Business Mailing Address
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Address Line | 714 SW DORION AVE
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City | PENDLETON
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State | OR
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Zip | 97801-2086
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Country | US
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Telephone | 541-276-2372
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL F BYRD
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Credential | DPM
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Telephone | 541-276-2372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | DP00295
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | DP00171
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | DP00357
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP00295
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP00357
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP00171
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License Number State | OR
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