Organization
GREAT WEST MEDICAL ASSOCIATES CARROL LLP
Active
Organization
GREAT WEST MEDICAL ASSOCIATES CARROL LLP
Active
Other names
Great West Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFFORD CARROL MD (PARTNER)
(702) 220-9865
Entity
Organization
Contact information
Practice address
3150 N TENAYA WAY, SUITE 525, LAS VEGAS, NV 89128-0443
(702) 220-9865
(702) 251-8196
Mailing address
PO BOX 34795, LAS VEGAS, NV 89133-4795
(702) 220-9865
(702) 251-8196
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750556940
—
NV
Enumeration date
04/28/2008
Last updated
06/22/2015
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