Organization
PEDIATRIC SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY A KOGUT M.D. (PRESIDENT)
(702) 233-8101
Entity
Organization
Contact information
Practice address
653 N TOWN CENTER DR, SUITE 507, LAS VEGAS, NV 89144-0514
(702) 233-8101
(702) 242-0726
Mailing address
653 N TOWN CENTER DR, SUITE 507, LAS VEGAS, NV 89144-0514
(702) 233-8101
(702) 242-0726
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
NV
Other
Enumeration date
03/30/2007
Last updated
08/22/2020
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