Organization
RUSSELL JAYNE MD LTD
Active
Organization
RUSSELL JAYNE MD LTD
Active
Other names
The Retina Center at Las Vegas
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL PATRICK JAYNE MD (PRESIDENT)
(702) 737-7258
Entity
Organization
Contact information
Practice address
6839 W CHARLESTON BLVD, LAS VEGAS, NV 89117-1635
(702) 737-7258
(702) 454-7258
Mailing address
PO BOX 50708, HENDERSON, NV 89016-0708
(702) 737-7258
(702) 454-7258
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9106
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018156
—
NV
01
—
DA5010
RAILROAD MEDICARE
NV
Enumeration date
07/05/2005
Last updated
09/27/2018
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