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Physicians Orthopaedic Surgery

Provider NPI: 1699041970

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
1505 WIGWAM PKWY STE 330  HENDERSON, NV 89074-8195 US
Tel: 702-878-0393  Fax: 702-902-4634

Business Mailing Address:
7455 W WASHINGTON AVE STE 160  LAS VEGAS, NV 89128-4356 US
Tel: 702-878-0393  Fax: 702-902-4580

NPI Information:
NPI: 1699041970
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Orthopaedic Surgery
Orthopaedic Surgery
Orthopaedic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207XS0106X





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