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NPI Code Detail

MEDICARE: FOOT & ANKLE SURGICAL GROUP, LLP

MEDICARE: FOOT & ANKLE SURGICAL GROUP, LLP
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
1332900000XNon-Pharmacy Dispensing Site8601NV
2332B00000XDurable Medical Equipment & Medical Supplies38610NV
3213ES0103XFoot & Ankle Surgery Podiatrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12990162OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1891748471
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOOT & ANKLE SURGICAL GROUP, LLP
Provider Business Mailing Address
First Line : 10561 JEFFREYS ST
Second Line : #110
City : HENDERSON
State : NV
Zip : 89052-4266
Country : US
Telephone Number : 702-456-3668
Fax Number : 702-456-6688
Provider Business Practice Location Address
First Line : 10561 JEFFREYS ST
Second Line : #110
City : HENDERSON
State : NV
Zip : 89052-4266
Country : US
Telephone Number : 702-456-3668
Fax Number : 702-456-6688
Authorized Official
Title or Position : GENERAL PARTNER
Name : GERALD TORGESEN
Credential : DPM
Telephone Number : 702-456-3668
Provider Enumeration Date : 05/18/2006
Last Update Date : 02/04/2014

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Directions to “FOOT & ANKLE SURGICAL GROUP, LLP ” Practice Location

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