# FOOT & ANKLE SURGICAL GROUP, LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Douglas S Stacey, DPM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194938936
- **Authorized official:** DOUGLAS S STACEY DPM (GENERAL PARTNER)
- **Authorized official phone:** (702) 456-3668

## Contact information

- **Practice address:** 999 ADAMS BLVD, \#104, BOULDER CITY, NV 89005-2244
- **Practice address phone:** (702) 293-0151
- **Practice address fax:** (702) 456-6688
- **Mailing address:** 129 W LAKE MEAD PKWY, \#B-18, HENDERSON, NV 89015-7055
- **Mailing address phone:** (702) 564-8022
- **Mailing address fax:** (702) 558-1522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 38610 | NV | — |

## Other

- **Enumeration date:** 05/08/2007
- **Last updated:** 10/06/2009