Doctor Name: | STEVEN D. FOOTE |
NPI Number: | 1619953304 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 2003005729 |
Business Practice Address: | 820 Illinois Republic, MO - 657381177 |
Business Phone Number: | 4172691910 |
Business Fax Number: | 4172691916 |
Mailing Address: | 820 S Illinois Ave, REPUBLIC |
State: | MO |
Postal Code: | 657381177 |
Phone Number: | 4172691910 |
Fax Number: | 4172691916 |
NPI Enumeration Date: | 12/15/2005 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2003005729 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |