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NPI Code Detail

MEDICARE: DR. DYLAN RICHARD FOORD D.O.

MEDICARE: DR. DYLAN RICHARD FOORD D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianDO2982NV

General Provider Information

NPI Number : 1063683969
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DYLAN RICHARD FOORD D.O.
Provider Business Mailing Address
First Line : PO BOX 370541
Second Line :
City : LAS VEGAS
State : NV
Zip : 89137-0541
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 620 SHADOW LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4119
Country : US
Telephone Number : 702-388-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2008
Last Update Date : 08/05/2024

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