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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
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