Organization
KACEY MD LLC
Active
Organization
KACEY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY LAZ ABANONU MD (OWNER)
(312) 823-6126
Entity
Organization
Contact information
Practice address
1033 RAILROAD FLAT CT, LAS VEGAS, NV 89138-4521
(312) 823-6126
Mailing address
1033 RAILROAD FLAT CT, LAS VEGAS, NV 89138-4521
(312) 823-6126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/10/2013
Last updated
03/17/2022
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