Organization
EASTERN PODIATRY LLC
Active
Other names
Eastern Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY W. WOOD D.P.M. (PRESIDENT)
(702) 434-2023
Entity
Organization
Contact information
Practice address
3777 S. PECOS MCLEOD, SUITE 103, LAS VEGAS, NV 89121-4265
(702) 434-2023
(702) 434-1976
Mailing address
3777 S. PECOS MCLEOD, SUITE 103, LAS VEGAS, NV 89121-4265
(702) 434-2023
(702) 434-1976
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0040
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C03159
MRR
NV
Enumeration date
01/31/2007
Last updated
11/02/2010
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