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General NPI Number Information
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NPI Number | 1497059240
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC FOOT AND ANKLE INSTITUTE, LLC
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 3175 SAINT ROSE PKWY SUITE 320
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City | HENDERSON
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State | NV
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Zip | 89052-3506
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Country | US
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Telephone | 702-997-9833
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Fax | 702-666-0413
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Provider Business Mailing Address
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Address Line | 3175 SAINT ROSE PKWY SUITE 320
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City | HENDERSON
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State | NV
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Zip | 89052-3506
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Country | US
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Telephone | 702-997-9833
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Fax | 702-666-0413
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Authorized Official
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Title or Position | OWNER
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Name | ROMAN SIBEL
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Credential | MD
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Telephone | 702-997-9833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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