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Organization

JEREMY LIPSHUTZ, MD, PLLC

Active
Other names
Collaborative Pain Management
Organization subpart
No

Provider details

NPI number
Authorized official
AMY MECHAM (DIR OF OPERATIONS)
(702) 948-8660
Entity
Organization

Contact information

Practice address
6120 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-6760
(702) 948-8660
(702) 948-8641
Mailing address
6120 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-6760
(702) 948-8660
(702) 948-8641

Taxonomy

Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
207LP2900X
Pain Medicine (Anesthesiology) Physician
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NV20201887338
NEVADA STATE BUSINESS LICENSE
NV
Enumeration date
09/16/2020
Last updated
11/30/2020
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