Healthcare Provider Details

I. General information

NPI: 1790916823
Provider Name (Legal Business Name): HORIZON SURGICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10561 JEFFREYS STREET
HENDERSON NV
89052-4179
US

IV. Provider business mailing address

10561 JEFFREYS STREET
HENDERSON NV
89052-4179
US

V. Phone/Fax

Practice location:
  • Phone: 702-724-8900
  • Fax: 702-982-8854
Mailing address:
  • Phone: 702-724-8900
  • Fax: 702-982-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT JACKSON TAIT
Title or Position: ORTHOPAEDIC SURGEON
Credential: M.D.
Phone: 702-565-6565