Organization
SOUTHWEST MEDICAL ASSOCIATES, INC
Active
Other names
Southwest Medical Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY CASTILLO (MEDICAL STAFF MANAGER)
(702) 480-2550
Entity
Organization
Contact information
Practice address
888 S RANCHO DRIVE, LAS VEGAS, NV 89106
(702) 877-8600
(702) 560-2928
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 560-2874
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
31797
NV
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002702006
—
NV
01
—
P00112269
RR MEDICARE
NV
Enumeration date
10/13/2006
Last updated
07/25/2023
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