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NPI Code Detail

MEDICARE: DR. ERIC JAE BRIMHALL M.D.

MEDICARE: DR. ERIC JAE BRIMHALL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician16193NV
2208100000XPhysical Medicine & Rehabilitation Physician88628611205UT
32081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianME150056FL

General Provider Information

NPI Number : 1134445109
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC JAE BRIMHALL M.D.
Provider Business Mailing Address
First Line : 7220 S CIMARRON RD STE 270
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2160
Country : US
Telephone Number : 702-912-4100
Fax Number : 702-912-4101
Provider Business Practice Location Address
First Line : 7220 S CIMARRON RD STE 270
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2160
Country : US
Telephone Number : 702-912-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2010
Last Update Date : 06/24/2022

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