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Organization
FRONTIER MEDICAL GROUP LLC
Active
Organization
FRONTIER MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUENNIE MANUEL (COO)
(775) 382-2000
Entity
Organization
Contact information
Practice address
825 S MAIN STREET #393, TONOPAH, NV 89049
(775) 382-2000
(775) 319-4130
Mailing address
3230 S BUFFALO DR # 105-10, LAS VEGAS, NV 89117-2505
(702) 686-8180
(775) 319-4130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
261QU0200X
Urgent Care Clinic/Center
—
NULL
291U00000X
Clinical Medical Laboratory
—
NULL
332900000X
Non-Pharmacy Dispensing Site
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
07/13/2022
Last updated
01/18/2023
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