Healthcare Provider Details

I. General information

NPI: 1568481828
Provider Name (Legal Business Name): CAMILLE A FALKNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 S. WATER ST #200
HENDERSON NV
89015
US

IV. Provider business mailing address

PO BOX 29502 #14970
LAS VEGAS NV
89126-9502
US

V. Phone/Fax

Practice location:
  • Phone: 702-476-3400
  • Fax: 702-476-3500
Mailing address:
  • Phone: 702-476-3400
  • Fax: 702-476-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number11935
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: