Healthcare Provider Details

I. General information

NPI: 1407933781
Provider Name (Legal Business Name): NUTAN KRISHNAKANT PARIKH M.D. LTD APC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 W HORIZON RIDGE PKWY STE
HENDERSON NV
89052-5015
US

IV. Provider business mailing address

PO BOX 777550
HENDERSON NV
89077-7550
US

V. Phone/Fax

Practice location:
  • Phone: 702-471-7779
  • Fax: 702-471-0484
Mailing address:
  • Phone: 702-471-7779
  • Fax: 702-471-0484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number5883
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD18958
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: