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NPI Code Detail

MEDICARE: JAEMI KEITH M.D.

MEDICARE: JAEMI KEITH 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
1207L00000XAnesthesiology Physician43285AZ
2207L00000XAnesthesiology Physician49547MN
3207L00000XAnesthesiology Physician16028NV
4207LP2900XPain Medicine (Anesthesiology) Physician16028NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215145792
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAEMI KEITH M.D.
Provider Business Mailing Address
First Line : 6064 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5350
Country : US
Telephone Number : 702-940-8007
Fax Number : 702-832-1940
Provider Business Practice Location Address
First Line : 6064 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5350
Country : US
Telephone Number : 702-940-8007
Fax Number : 702-832-1940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 04/18/2024

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Practice Fax: 702-832-1940

Directions to “ JAEMI KEITH M.D.” Practice Location

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