Individual
GERARD JOHN CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
6900 N PECOS RD, N LAS VEGAS, NV 89086-4400
(702) 791-9000
Mailing address
3196 S MARYLAND PKWY, SUITE 101, LAS VEGAS, NV 89109
(702) 731-8099
(702) 731-8292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA873
NV
363AS0400X
Surgical Physician Assistant
Primary
PA873
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504648
—
NV
05
—
991530
—
AZ
Enumeration date
03/17/2006
Last updated
06/29/2023
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