Organization
MIKE O'CALLAGHAN MILITARY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS K KONICKE (IDMT)
(702) 653-2273
Entity
Organization
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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