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General NPI Number Information
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NPI Number | 1083003891
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Entity Type | Organization
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Legal Business Name | ROGER B REED DPM PC
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 2649 W HORIZON RIDGE PKWY SUITE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4801
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Country | US
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Telephone | 702-565-6641
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Fax | 702-565-9249
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Provider Business Mailing Address
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Address Line | 2649 W HORIZON RIDGE PKWY SUITE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4801
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Country | US
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Telephone | 702-565-6641
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Fax | 702-565-9249
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. VERONICA M DIAZ
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Credential |
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Telephone | 702-565-6641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | NV8905
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License Number State | NV
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