Individual provider · NPI-1

Jeremy Anderson, DPM

Podiatrist · Las Vegas, NV

NPI number1144714296
StatusActive
Last updated in NPPESAug 3, 2022

Details

NPI
1144714296
Entity type
Individual (NPI-1)
Name
Jeremy Anderson
Credential
DPM
Sex
Male
Sole proprietor
No
Enumeration date
Jun 20, 2018
Certification date
Aug 3, 2022
Last updated
Aug 3, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X Podiatrist2077NVYes
213E00000X Podiatrist11354714-0501UT
390200000X Student in an Organized Health Care Education/Training Program–UT
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

1416 S Jones Blvd
Las Vegas, NV 89146-1231

Phone 702-878-1400 · Fax 888-263-5542

Mailing address

500 Foothill Dr
Slc, UT 84148-0001

Other practice locations

500 Foothill Dr
Slc, UT 84148-0001

Phone 801-582-1565

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