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NPI Code Detail

MEDICARE: WALTER REED JAUSSI MD

MEDICARE: WALTER REED JAUSSI MD
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
1207W00000XOphthalmology Physician49198431205UT
2207W00000XOphthalmology Physician14252NV

General Provider Information

NPI Number : 1790896660
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER REED JAUSSI MD
Provider Business Mailing Address
First Line : 5840 W CRAIG RD
Second Line : STE. 120 PMB 254
City : LAS VEGAS
State : NV
Zip : 89130-2561
Country : US
Telephone Number : 702-724-2020
Fax Number : 702-405-5541
Provider Business Practice Location Address
First Line : 5871 W CRAIG RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-2575
Country : US
Telephone Number : 702-724-2020
Fax Number : 702-724-2800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 10/10/2016

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Directions to “ WALTER REED JAUSSI MD” Practice Location

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