Provider Demographics
NPI:1386976504
Name:WILLIAM A FOOTE DPM PA
Entity type:Organization
Organization Name:WILLIAM A FOOTE DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOOTE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-890-0255
Mailing Address - Street 1:292 HUGHES DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQ
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1323
Mailing Address - Country:US
Mailing Address - Phone:609-890-0255
Mailing Address - Fax:609-584-7109
Practice Address - Street 1:292 HUGHES DR
Practice Address - Street 2:
Practice Address - City:HAMILTON SQ
Practice Address - State:NJ
Practice Address - Zip Code:08690-1323
Practice Address - Country:US
Practice Address - Phone:609-890-0255
Practice Address - Fax:609-584-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-14
Last Update Date:2010-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00090500213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT44617Medicare UPIN