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Individual
L BRUCE FORD
Active
Individual
L BRUCE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
23
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211603
—
NV
01
—
480480550
MRR
NV
01
—
490001810
RR INDIVIDUAL PROV # - EXPIRED 2/17/2008
NV
01
—
CH8729
RR GROUP PROVIDER # - EXPIRED 2/17/2008
NV
Enumeration date
12/14/2005
Last updated
04/28/2008
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