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Individual

RAYMOND VINCENT KELLOGG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4675 W FLAMINGO RD, LAS VEGAS, NV 89103-3795
(702) 364-1252
(702) 364-9716
Mailing address
4675 W FLAMINGO RD, LAS VEGAS, NV 89103-3795
(702) 949-2020
(702) 948-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0331
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2502825
NV
01
410041956
RAILROAD MEDICARE
NV
Enumeration date
01/09/2007
Last updated
07/08/2007
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