Healthcare Provider Details

I. General information

NPI: 1043183338
Provider Name (Legal Business Name): MEDLEGAL TEAMS KHAVKIN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5380 S RAINBOW BLVD STE 306
LAS VEGAS NV
89118-1880
US

IV. Provider business mailing address

5380 S RAINBOW BLVD STE 306
LAS VEGAS NV
89118-1880
US

V. Phone/Fax

Practice location:
  • Phone: 702-603-5455
  • Fax: 702-673-4134
Mailing address:
  • Phone: 702-603-5455
  • Fax: 702-673-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: YEVGENIY A KHAVKIN
Title or Position: OWNER
Credential: MD
Phone: 773-339-4310