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General NPI Number Information
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NPI Number | 1891748471
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE SURGICAL GROUP, LLP
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 10561 JEFFREYS ST #110
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City | HENDERSON
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State | NV
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Zip | 89052-4266
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Country | US
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Telephone | 702-456-3668
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Fax | 702-456-6688
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Provider Business Mailing Address
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Address Line | 10561 JEFFREYS ST #110
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City | HENDERSON
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State | NV
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Zip | 89052-4266
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Country | US
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Telephone | 702-456-3668
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Fax | 702-456-6688
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | GERALD TORGESEN
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Credential | DPM
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Telephone | 702-456-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 8601
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 38610
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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