# EDDIEPMD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699226274
- **Authorized official:** LARRY ROBINSON (OFFICE MANAGER)
- **Authorized official phone:** (702) 386-0909

## Contact information

- **Practice address:** 601 S RANCHO DR, STE 6, LAS VEGAS, NV 89106-4899
- **Practice address phone:** (702) 386-0909
- **Practice address fax:** (702) 386-0707
- **Mailing address:** 601 S RANCHO DR, STE 6, LAS VEGAS, NV 89106-4899
- **Mailing address phone:** (702) 386-0909
- **Mailing address fax:** (702) 386-0707

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 8581 | NV | Yes |

## Other

- **Enumeration date:** 10/19/2016
- **Last updated:** 11/14/2018