Provider Demographics
NPI:1164864963
Name:ANTHONY V BORGIA DPM PLLC
Entity Type:Organization
Organization Name:ANTHONY V BORGIA DPM PLLC
Other - Org Name:SILVER STATE FOOT & ANKLE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:V
Authorized Official - Last Name:BORGIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:702-998-7409
Mailing Address - Street 1:2410 FIRE MESA ST
Mailing Address - Street 2:STE 160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9016
Mailing Address - Country:US
Mailing Address - Phone:702-947-2005
Mailing Address - Fax:702-964-1416
Practice Address - Street 1:2410 FIRE MESA ST
Practice Address - Street 2:STE 160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9016
Practice Address - Country:US
Practice Address - Phone:702-947-2005
Practice Address - Fax:702-964-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8901213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty