Organization
GASTROINTESTINAL DIAGNOSTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK GERARD LONDON MBA/MHA (SENIOR CONSULTANT)
(702) 737-7555
Entity
Organization
Contact information
Practice address
3196 S MARYLAND PKWY, SUITE 207, LAS VEGAS, NV 89109-2305
(702) 369-3400
Mailing address
3196 S MARYLAND PKWY, SUITE 207, LAS VEGAS, NV 89109-2305
(702) 369-3400
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
477ASC-8
NV
Other
Enumeration date
10/10/2006
Last updated
10/18/2007
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