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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