MEDICARE: GENERAL SURGERY ASSOCIATES

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	174400000X	Specialist

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

General Provider Information

NPI Number	:	1962423178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERAL SURGERY ASSOCIATES

Provider Business Mailing Address
First Line	:	5380 S RAINBOW BLVD STE 330
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1880
Country	:	US
Telephone Number	:	702-382-8222
Fax Number	:	702-382-3935

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD STE 330
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1880
Country	:	US
Telephone Number	:	702-382-8222
Fax Number	:	702-382-3935

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	MS. CINDY L JOHNSON
Credential	:
Telephone Number	:	702-382-8222

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	02/28/2019

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Directions to “GENERAL SURGERY ASSOCIATES ” Practice Location

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