Doctor Name: | MR. FONCO HOWARD |
NPI Number: | 1215960513 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | POD000769 |
Business Practice Address: | 2579 Chamblee Tucker Rd Chamblee, GA - 303413515 |
Business Phone Number: | 7704529600 |
Business Fax Number: | 7704528303 |
Mailing Address: | 12476 Hopewell Rd, ALPHARETTA |
State: | GA |
Postal Code: | 300041347 |
Phone Number: | 7704529600 |
Fax Number: | 7704528303 |
NPI Enumeration Date: | 07/09/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | POD000769 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |