MEDICARE: DUKE FORAGE ANSON NEUROSURGICAL LLP

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	207T00000X	Neurological Surgery Physician

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	:	1649777608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUKE FORAGE ANSON NEUROSURGICAL LLP

Provider Business Mailing Address
First Line	:	PO BOX 95306
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89193-5306
Country	:	US
Telephone Number	:	702-851-0792
Fax Number	:	702-851-0797

Provider Business Practice Location Address
First Line	:	8530 W SUNSET RD STE 250
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2245
Country	:	US
Telephone Number	:	702-851-0792
Fax Number	:	702-851-0797

Authorized Official
Title or Position	:	PARTNER OWNER & PROVIDER
Name	:	DEREK A DUKE
Credential	:
Telephone Number	:	702-896-0940

Provider Enumeration Date	:	04/06/2018
Last Update Date	:	04/06/2018

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