Individual
PATRICK TICMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119
(702) 737-1880
(702) 650-2458
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12055
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511024
—
NV
05
—
100511025
—
NV
05
—
1306935473
—
NV
Enumeration date
10/12/2006
Last updated
11/19/2024
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