Provider Demographics
NPI:1467013003
Name:FOOTE, COURTNEY M (DPM)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:M
Last Name:FOOTE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 W MAIN STREET RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-9467
Mailing Address - Country:US
Mailing Address - Phone:585-344-1677
Mailing Address - Fax:585-344-2105
Practice Address - Street 1:3922 W MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-9467
Practice Address - Country:US
Practice Address - Phone:585-344-1677
Practice Address - Fax:585-344-2105
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN007240213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty