Healthcare Provider Details

I. General information

NPI: 1578322632
Provider Name (Legal Business Name): E3 MEDICAL CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E FLAMINGO RD STE E
LAS VEGAS NV
89121-5208
US

IV. Provider business mailing address

2950 E FLAMINGO RD STE E
LAS VEGAS NV
89121-5208
US

V. Phone/Fax

Practice location:
  • Phone: 206-300-8297
  • Fax:
Mailing address:
  • Phone: 206-300-8297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSEPH ELDRIDGE
Title or Position: OWNER
Credential: APRN
Phone: 801-310-9489