MEDICARE: BLAKE THOMAS SAVAGE

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	0103301343	VA
2	213E00000X	Podiatrist	0103301343	VA

General Provider Information

NPI Number	:	1124580410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLAKE THOMAS SAVAGE

Provider Business Mailing Address
First Line	:	3175 SAINT ROSE PKWY STE 320
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3508
Country	:	US
Telephone Number	:	702-997-9833
Fax Number	:	702-997-9844

Provider Business Practice Location Address
First Line	:	3175 SAINT ROSE PKWY STE 320
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3508
Country	:	US
Telephone Number	:	702-997-9833
Fax Number	:	702-666-0413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	06/29/2023

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Directions to “ BLAKE THOMAS SAVAGE ” Practice Location

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