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NPI Code Detail

MEDICARE: LONE MOUNTAIN MEDICAL CENTRE

MEDICARE: LONE MOUNTAIN MEDICAL CENTRE
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
1207Q00000XFamily Medicine Physician493NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CS13274OTHERNVNV STATE BOARD OF PHARMAC
2493OTHERNVNV STATE BOARD OF OSTEOPA

General Provider Information

NPI Number : 1356389456
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONE MOUNTAIN MEDICAL CENTRE
Provider Business Mailing Address
First Line : 4830 W LONE MOUNTAIN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-2239
Country : US
Telephone Number : 702-645-8126
Fax Number : 702-645-2828
Provider Business Practice Location Address
First Line : 4830 W LONE MOUNTAIN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-2239
Country : US
Telephone Number : 702-645-8126
Fax Number : 702-645-2828
Authorized Official
Title or Position : MD
Name : WELDON EUGENE BOND
Credential : D.O.
Telephone Number : 702-645-8126
Provider Enumeration Date : 06/02/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
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1619906641 — THE VON'S COMPANIES
Practice Location Address:
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Practice Fax: 702-645-1151
1598799009 — BARRY A KENNEDY D.D.S
Practice Location Address:
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89130-2239
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Practice Fax: 702-655-9565
1942334081 — DR. GREGORY KEN CAHOON DDS
Practice Location Address:
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1831210640 — MS. MOLLY BEAM
Practice Location Address:
4894 W LONE MOUNTAIN RD # 143
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89130-2239
Practice Phone: 702-341-0402
Practice Fax:

Directions to “LONE MOUNTAIN MEDICAL CENTRE ” Practice Location

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