Provider Demographics
NPI:1205017654
Name:NORTHERN NEVADA FOOT & ANKLE
Entity Type:Organization
Organization Name:NORTHERN NEVADA FOOT & ANKLE
Other - Org Name:DRAPER AND PATTON, LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-753-4044
Mailing Address - Street 1:1775 BROWNING WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8338
Mailing Address - Country:US
Mailing Address - Phone:775-753-4044
Mailing Address - Fax:
Practice Address - Street 1:1775 BROWNING WAY STE 101
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8338
Practice Address - Country:US
Practice Address - Phone:775-753-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV9506213ES0103X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV4406180001Medicare NSC