MEDICARE: JASON H NIELSON 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	207XP3100X	Pediatric Orthopaedic Surgery Physician	11034571-1205	UT
2	207X00000X	Orthopaedic Surgery Physician	11453	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1477520575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON H NIELSON M.D.

Provider Business Mailing Address
First Line	:	14 DAISY MEADOW TERRACE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-1500
Country	:	US
Telephone Number	:	702-263-1199
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 E. WINDMILL LANE
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1903
Country	:	US
Telephone Number	:	702-434-6920
Fax Number	:	702-434-1524

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	03/27/2019

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Directions to “ JASON H NIELSON M.D.” Practice Location

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