Individual
JESSE A BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10624 S EASTERN AVE STE A-955, HENDERSON, NV 89052-2982
(702) 407-7700
(702) 407-7016
Mailing address
620 SHADOW LN, LAS VEGAS, NV 89106-4119
(702) 388-8000
(702) 388-8431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO3128
NV
207R00000X
Internal Medicine Physician
SL1430
NV
Other
Enumeration date
05/04/2019
Last updated
07/05/2022
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