Organization
BOULDER FOOT & ANKLE CENTER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESLEY W LYON D.P.M. (OWNER)
(702) 293-5036
Entity
Organization
Contact information
Practice address
999 ADAMS BLVD, STE 103, BOULDER CITY, NV 89005-2244
(702) 293-5036
(866) 409-1683
Mailing address
PO BOX 1344, OVERTON, NV 89040-1344
(702) 293-5036
(866) 409-1683
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
NV9807
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002102008
—
NV
01
—
480031437
RAILROAD MEDICARE
NV
Enumeration date
02/22/2007
Last updated
10/12/2011
Update your record
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