| Organization Name: | ACHILLES FOOT AND ANKLE SPECIALIST PLLC |
| NPI Number: | 1003166455 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JO ANN JOHNSON (PROVIDER RELATIONS SPECIALIST) |
| Mailing Address: | 2865 Siena Heights Dr Suite 200 Henderson |
| State: | NV US |
| Postal Code: | 890524167 |
| Phone Number: | 7028249655 |
| Fax Number: | 7028894213 |
| NPI Enumeration Date: | 09/13/2012 |
| NPI Last Update Date: | 09/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |