Individual
MR. ANTHONY JOHN MARLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4275 BURNHAM AVE STE 340, LAS VEGAS, NV 89119-5400
(702) 734-6363
(702) 734-6374
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0256
NV
363AM0700X
Medical Physician Assistant
PA0256
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376880708
—
NV
01
—
PA0256
STATE LICENSE
NV
Enumeration date
01/04/2013
Last updated
02/02/2023
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