Individual
PRAVEEN JAYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 N RAINBOW BLVD STE 350, LAS VEGAS, NV 89107-1188
(480) 494-2465
Mailing address
161 E RIVULON BLVD STE 210, GILBERT, AZ 85297-0087
(480) 244-1724
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15182
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15182
NV MEDICAL LICENSE
NV
Enumeration date
07/10/2007
Last updated
03/22/2024
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