Organization
NOMMIS CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMMON WILCOX MD (MEDICAL DIRECTOR)
(702) 785-4114
Entity
Organization
Contact information
Practice address
4550 E CHARLESTON BLVD, LAS VEGAS, NV 89104-5525
(702) 785-4114
Mailing address
6421 ABERDEEN LN, LAS VEGAS, NV 89107-1268
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2009007880
MO
207QA0505X
Adult Medicine Physician
Primary
11588
NV
207QA0505X
Adult Medicine Physician
6968998-1205
UT
207QA0505X
Adult Medicine Physician
MD033724E
PA
208VP0000X
Pain Medicine Physician
11588
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000185023
HIGHMARK BC/BS
PA
05
—
100510116
—
NV
Enumeration date
01/30/2014
Last updated
01/30/2014
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