Provider Demographics
NPI:1497378517
Name:LAS VEGAS FOOT AND ANKLE CENTERS LLP
Entity Type:Organization
Organization Name:LAS VEGAS FOOT AND ANKLE CENTERS LLP
Other - Org Name:LAS VEGAS FOOT AND ANKLE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:B
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:702-565-6641
Mailing Address - Street 1:2649 W HORIZON RIDGE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4801
Mailing Address - Country:US
Mailing Address - Phone:702-565-6641
Mailing Address - Fax:702-565-9249
Practice Address - Street 1:2649 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4801
Practice Address - Country:US
Practice Address - Phone:702-565-6641
Practice Address - Fax:702-565-9249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1386177327OtherNPI
1689802332OtherNPI
1558252224OtherNPI
1194068767OtherNPI