MEDICARE: YEVGENIY A KHAVKIN M.D.

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	01066362A	IN
2	207T00000X	Neurological Surgery Physician	13271	NV
3	207T00000X	Neurological Surgery Physician	D63005	MD

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922055128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEVGENIY A KHAVKIN M.D.

Provider Business Mailing Address
First Line	:	5380 S RAINBOW BLVD STE 306
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1880
Country	:	US
Telephone Number	:	702-888-1188
Fax Number	:	702-476-8995

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD STE 306
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1880
Country	:	US
Telephone Number	:	702-888-1188
Fax Number	:	702-476-8995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	09/26/2025

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Directions to “ YEVGENIY A KHAVKIN M.D.” Practice Location

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