MEDICARE: DR. JESSICA BEAR 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
1	207X00000X	Orthopaedic Surgery Physician	18021	NV
2	207XX0801X	Orthopaedic Trauma Physician	18021	NV

General Provider Information

NPI Number	:	1144630344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA BEAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4750 W OAKEY BLVD STE 401
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1535
Country	:	US
Telephone Number	:	702-724-8877
Fax Number	:	702-878-3952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	12/20/2021

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