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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