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Organization

UNIVERSITY OF NEVADA SCHOOL OF MEDICINE MULTI-SPEC GRP PRACT SO

Active
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Organization

UNIVERSITY OF NEVADA SCHOOL OF MEDICINE MULTI-SPEC GRP PRACT SO

Active
Other names
MedSchool Associates South
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JOANNE HANSEN (CREDENTIALING SPECIALIST)
(702) 671-2395
Entity
Organization

Contact information

Practice address
2231 W CHARLESTON BLVD, 1ST FLOOR, LAS VEGAS, NV 89102-2254
(702) 676-3650
(702) 676-3635
Mailing address
1701 W CHARLESTON BLVD, SUITE 110, LAS VEGAS, NV 89102-2325
(702) 671-2211
(702) 380-2913

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208600000X
Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100500484
NV
Enumeration date
08/14/2014
Last updated
08/14/2014
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