Individual
DR. HOMER E. FOUTY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-1000
Mailing address
361 COLLINS ST, ORMOND BEACH, FL 32174-6906
(386) 682-9612
(386) 615-1022
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY5097
FL
103TC0700X
Clinical Psychologist
Primary
PY5097
FL
Other
Enumeration date
06/01/2006
Last updated
03/29/2018
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