Individual
BRUCE M FOOTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5999
(907) 458-5178
(907) 458-5180
Mailing address
1001 NOBLE ST, FAIRBANKS, AK 99701-4922
(907) 459-3500
(907) 459-3532
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5031
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018156
—
AK
Enumeration date
04/30/2007
Last updated
10/28/2016
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