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NPI Code Detail

MEDICARE: ADELBERT SCOTT WADSWORTH PA-C

MEDICARE: ADELBERT SCOTT WADSWORTH PA-C
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
1363AM0700XMedical Physician AssistantNV

General Provider Information

NPI Number : 1699053660
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELBERT SCOTT WADSWORTH PA-C
Provider Business Mailing Address
First Line : 7150 W SUNSET RD STE 201A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1981
Country : US
Telephone Number : 702-385-4342
Fax Number :
Provider Business Practice Location Address
First Line : 7500 SMOKE RANCH RD STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0373
Country : US
Telephone Number : 702-233-0727
Fax Number : 702-442-1886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2011
Last Update Date : 07/30/2024

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Directions to “ ADELBERT SCOTT WADSWORTH PA-C” Practice Location

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