Individual
L BRUCE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2321 PYRAMID WAY, SPARKS, NV 89431-8700
(775) 331-2321
(775) 331-2008
Mailing address
2321 PYRAMID WAY, SPARKS, NV 89431-8700
(775) 331-2321
(775) 331-2008
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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