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Organization

JAGANNATH S. SURPURE, M.D.P.C.

Active
Other names
Children's Urgent Care & Pediatric Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAGANNATH S. SURPURE M.D. (MEDICAL DIRECTOR)
(702) 898-6400
Entity
Organization

Contact information

Practice address
1600 W SUNSET RD, SUITE A, HENDERSON, NV 89014-2654
(702) 898-6400
(702) 898-7032
Mailing address
1600 W SUNSET RD, SUITE A, HENDERSON, NV 89014-2654
(702) 898-6400
(702) 898-7032

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6591
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2019436
NV
05
3102430
NV
Enumeration date
02/08/2007
Last updated
08/22/2020
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