Individual
PAUL PARCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 737-1880
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 838-8265
(702) 804-3788
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9006
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505466
—
NV
01
—
100505489
MEDICAID
NV
05
—
1245232750
—
NV
Enumeration date
08/15/2005
Last updated
01/04/2019
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