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Individual

ANTHONY SCOCCOLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
98 E LAKE MEAD PKWY STE 105, HENDERSON, NV 89015-6443
(702) 823-4300
Mailing address
1785 E SAHARA AVE STE 340, LAS VEGAS, NV 89104-3717
(702) 823-4300

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
363A00000X
Physician Assistant
PA3437
NV
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
PA3437
NV
363AM0700X
Medical Physician Assistant
Primary
363AS0400X
Surgical Physician Assistant
PA3437
NV

Other

Enumeration date
12/06/2024
Last updated
04/09/2026
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