Healthcare Provider Details

I. General information

NPI: 1801966791
Provider Name (Legal Business Name): ATKINSON, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 MEADOWS LN
LAS VEGAS NV
89107-3112
US

IV. Provider business mailing address

3802 MEADOWS LN
LAS VEGAS NV
89107-3112
US

V. Phone/Fax

Practice location:
  • Phone: 702-478-8446
  • Fax: 702-405-2263
Mailing address:
  • Phone: 702-478-8446
  • Fax: 702-405-2263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberDO1509
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License NumberDO1509
License Number StateNV

VIII. Authorized Official

Name: DR. JAMES DEE ATKINSON
Title or Position: OWNER
Credential: M.D.
Phone: 702-313-8446