Organization
RETINA CONSULTANTS OF NEVADA LLP
Active
Organization
RETINA CONSULTANTS OF NEVADA LLP
Active
Other names
Retina Consultants of Nevada
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRIM (CREDENTIALING SPECIALIST)
(702) 202-4776
Entity
Organization
Contact information
Practice address
3650 S POINTE CIR STE 210, LAUGHLIN, NV 89029-0423
(702) 369-0200
(702) 243-8383
Mailing address
2850 W HORIZON RIDGE PKWY STE 300, HENDERSON, NV 89052-4395
(702) 202-4776
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
Q07000085114832
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506154
—
NV
01
—
CC6528
BCBS ANTHEM GRP
NV
Enumeration date
09/11/2006
Last updated
01/17/2022
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