Healthcare Provider Details

I. General information

NPI: 1578123105
Provider Name (Legal Business Name): MCWHORTER EF ANESTHESIA, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 GREEN VALLEY PKWY 112
HENDERSON NV
89014
US

IV. Provider business mailing address

PO BOX 93358
LAS VEGAS NV
89193-3358
US

V. Phone/Fax

Practice location:
  • Phone: 702-487-6510
  • Fax: 702-405-7960
Mailing address:
  • Phone: 702-487-6510
  • Fax: 702-405-7960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: YI MCWHORTER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 562-843-1024