Organization Name: | GARY B. PITT DPM INC |
NPI Number: | 1306032180 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY BYRON PITT (PRESIDENT) |
Mailing Address: | 59-229 Alapio Rd Haleiwa |
State: | HI US |
Postal Code: | 967129604 |
Phone Number: | 8086387589 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2007 |
NPI Last Update Date: | 09/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | PO136 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |