DR. LOUIS VINCENT DEFAZIO II (NPI# 1790105385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790105385 |
| Entity Type | Individual |
| Full Name | DR. LOUIS VINCENT DEFAZIO II |
| Credential | DPM |
| Practice Address |
6100 Daylong Ln Ste 208 Clarksville MD 21029-1655 |
| Mailing Address |
1600 E Gude Dr Ste 200 Rockville MD 20850-1496 |
| Practice Telephone | 4435358770 |
| Practice Fax Number | 4435358775 |
| Mailing Telephone | 3019337133 |
| Mailing Fax Number | 3019337137 |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2018-11-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 01625 | MD | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 N Academy Ave, Danville, PA 178229800 | 5702716211 |
| Street Address |
6100 DAYLONG LN STE 208 |
| City | CLARKSVILLE |
| State | MD |
| Zip Code | 21029-1655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710436407 | Central Maryland Oral and Facial Surgical Arts of Clarksville, LLC | Dentist | 12431 Clarksville Pike, Route 108, Clarksville, MD 21029 | 2016-09-23 |
| 1740647262 | Darren Joseph | Physical Therapist | 6151 Daylong Lane, Clarksville, MD 21029 | 2016-01-28 |
| 1619302437 | Ashley Kneale | Physical Therapist | 6408 Silent Moon Run, Clarksville, MD 21029 | 2013-09-11 |
| 1780949693 | Jane Choi Council | Optometrist | 12345 Wake Forest Rd Ste E, Clarksville, MD 21029 | 2012-07-06 |
| 1598035248 | Jeffrey Stuart Abrams | Internal Medicine | 5073ten Oaks Rd, Clarksville, MD 21029 | 2012-01-11 |
| 1902102528 | Claudia Joe Salter | Psychologist | 6100 Daylong Ln Ste 103, Clarksville, MD 21029 | 2011-01-28 |
| 1285892430 | Mary Carol Wayda | Social Worker | 5905 Tall Branches Pass, Clarksville, MD 21029 | 2008-05-23 |
| 1407978422 | Basil Saiedy Dds LLC | Dentist | 6100 Day Long Lane, Suite 101, Clarksville, MD 21029 | 2007-04-03 |
| 1629329214 | Dina Michele Singer | Acupuncturist | 12451 Clarksville Pike, Clarksville, MD 21029 | 2012-09-24 |
| 1689796609 | Basil Saiedy | Dentist | 6100 Day Long Lane, Suite 101, Clarksville, MD 21029 | 2007-04-03 |
| Find all providers in zip 21029 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700174604 | Jenna Beth Vaught | Podiatrist | 746 Parkwood Dr, Clarksville, IN 47129-1273 | 2011-07-13 |
| 1669635280 | Family Foot Clinic | Podiatrist | 203 Sevier St, Clarksville, AR 72830 | 2008-07-03 |
| 1508954561 | David H. Bolonkin, Dpm, Inc | Podiatrist | 1402 Blackiston Mill Rd, Clarksville, IN 47129-2279 | 2006-10-11 |
| 1740374818 | Jeff Frank Resimont | Podiatrist | 203 W Sevier St, Clarksville, AR 72830-3627 | 2006-10-03 |
| 1982621603 | Paulo R.t. Yen | Podiatrist | 1735 Haynes St, Clarksville, TN 37043-4598 | 2006-07-17 |
| 1114993078 | Ross E Taubman | Podiatrist | 6100 Daylong Ln, Suite 102, Clarksville, MD 21029-1626 | 2006-02-28 |
| 1942200076 | Michael B. Schussler | Podiatrist | 1762 Memorial Dr, Clarksville, TN 37043-4562 | 2005-07-29 |
| 1780050542 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 6100 Daylong Ln, Suite 208, Clarksville, MD 21029-1626 | 2015-08-17 |
| 1902192156 | Casey Robert Friske | Podiatrist | 6100 Daylong Ln, Suite 208, Clarksville, MD 21029-1626 | 2011-06-27 |
| 1538332010 | David E Smith | Podiatrist | 647 Dunlop Ln, Suite 209, Clarksville, TN 37040-5165 | 2008-04-07 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 21029 |
Please comment or provide details below to improve the information on DR. LOUIS VINCENT DEFAZIO II.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.