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Organization
DUCKWATER SHOSHONE TRIBE
Active
Organization
DUCKWATER SHOSHONE TRIBE
Active
Other names
Duckwater Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY MILLETT (TRIBAL MANAGER CHAIRMAN)
(775) 863-0227
Entity
Organization
Contact information
Practice address
502 DUCKWATER FALLS RD, DUCKWATER, NV 89314-0087
(775) 863-0222
(775) 863-0142
Mailing address
PO BOX 140087, DUCKWATER, NV 89314-0087
(775) 863-0222
(775) 863-0142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003112002
HEALTHY KIDS SCREENING
NV
05
—
004712001
—
NV
Enumeration date
08/12/2005
Last updated
07/21/2022
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