Organization
DAVID J LOISELLE DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JOHN LOISELLE DPM (OWNER)
(727) 596-9703
Entity
Organization
Contact information
Practice address
14219 WALSINGHAM RD, SUITE K, LARGO, FL 33774-3249
(727) 596-9703
(727) 596-9703
Mailing address
14219 WALSINGHAM RD, SUITE K, LARGO, FL 33774-3249
(727) 596-9703
(727) 596-9703
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO 1880
FL
213ER0200X
Radiology Podiatrist
PO 1880
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO 1880
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029762300
—
FL
Enumeration date
07/26/2010
Last updated
07/28/2010
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