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Individual

DR. KENNETH JARVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1200 S 4TH ST STE 111, LAS VEGAS, NV 89104-1046
(702) 810-1748
(702) 837-8292
Mailing address
4333 OASIS VALLEY AVE, NORTH LAS VEGAS, NV 89085-2335
(702) 810-1748
(702) 837-8292

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0108
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100501920
NV
01
P00138284
RAILROAD MEDICARE
OH
Enumeration date
05/27/2005
Last updated
03/17/2018
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