Organization
UNSOM MULTISPECIALTY GROUP PRACTICE SOUTH, INC
Active
Other names
MedSchool Associates South
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANNE HANSEN (CREDENTIALING SPECIALIST)
(702) 671-2395
Entity
Organization
Contact information
Practice address
3121 S MARYLAND PKWY, SUITE 400, LAS VEGAS, NV 89109-2307
(702) 650-2500
(702) 650-2220
Mailing address
1701 W CHARLESTON BLVD, SUITE 490, LAS VEGAS, NV 89102-2325
(702) 671-2278
(702) 671-2245
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184601239
GROUP NPI
NV
Enumeration date
01/17/2013
Last updated
02/03/2016
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