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NPI Code Detail

MEDICARE: CARSEN POPELKA OD

MEDICARE:   CARSEN  POPELKA  OD
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
1152W00000XOptometrist1141NV

General Provider Information

NPI Number : 1669107298
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARSEN POPELKA OD
Provider Business Mailing Address
First Line : 3836 ALPINE BYPASS AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-6618
Country : US
Telephone Number : 404-805-5072
Fax Number :
Provider Business Practice Location Address
First Line : 4388 E CRAIG RD STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-1962
Country : US
Telephone Number : 702-643-9191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2022
Last Update Date : 07/18/2022

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Directions to “ CARSEN POPELKA OD” Practice Location

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