MEDICARE: ORTHOPAEDIC SPECIALISTS OF NEVADA

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1871761627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPAEDIC SPECIALISTS OF NEVADA

Provider Business Mailing Address
First Line	:	701 S TONOPAH DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4030
Country	:	US
Telephone Number	:	702-388-1008
Fax Number	:	702-388-1841

Provider Business Practice Location Address
First Line	:	7200 CATHEDRAL ROCK DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0466
Country	:	US
Telephone Number	:	702-256-8500
Fax Number	:	702-256-8527

Authorized Official
Title or Position	:	SENIOR PARTNER
Name	:	DR. DONALD MACKAY
Credential	:	M.D.
Telephone Number	:	702-388-1008

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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