Individual
MR. GAVIN HOLMES POPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2020 PALOMINO LN STE 110, LAS VEGAS, NV 89106-4892
(702) 474-7200
(702) 474-0009
Mailing address
2020 PALOMINO LN STE 110, LAS VEGAS, NV 89106-4892
(702) 474-7200
(702) 474-0009
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
909
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506320
—
NV
01
—
CC7717
BXBS
—
01
—
P00835002
RR MEDICARE
—
Enumeration date
01/06/2006
Last updated
11/20/2024
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