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NPI Code Detail

MEDICARE: DR. JAMES ALAN AVERETT DPM

MEDICARE: DR. JAMES ALAN AVERETT DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist2012NV

General Provider Information

NPI Number : 1598016255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES ALAN AVERETT DPM
Provider Business Mailing Address
First Line : 4580 S EASTERN AVE STE 30
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6100
Country : US
Telephone Number : 435-313-6535
Fax Number :
Provider Business Practice Location Address
First Line : 4580 S EASTERN AVE STE 30
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6100
Country : US
Telephone Number : 435-313-6535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2012
Last Update Date : 06/18/2015

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Directions to “ DR. JAMES ALAN AVERETT DPM” Practice Location

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