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Organization

EAR, NOSE & THROAT ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEROLD E BOYERS M.D. (PRESIDENT/PARTNER)
(702) 382-3221
Entity
Organization

Contact information

Practice address
700 SHADOW LN, SUITE 235, LAS VEGAS, NV 89106-4126
(702) 382-3221
(702) 382-1822
Mailing address
700 SHADOW LANE, SUITE 235, LAS VEGAS, NV 89106
(702) 382-3221
(702) 382-1822

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
038511480
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100508181
NV
01
CQ3081
RR MEDICARE
NV
Enumeration date
10/25/2006
Last updated
02/22/2008
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