Healthcare Provider Details

I. General information

NPI: 1194995282
Provider Name (Legal Business Name): FLORENCE JAMESON M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5281 S EASTERN AVE
LAS VEGAS NV
89119-2311
US

IV. Provider business mailing address

5281 S EASTERN AVE
LAS VEGAS NV
89119-2311
US

V. Phone/Fax

Practice location:
  • Phone: 702-262-9676
  • Fax: 702-262-9707
Mailing address:
  • Phone: 702-262-9676
  • Fax: 702-262-9707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number5203
License Number StateNV

VIII. Authorized Official

Name: DR. FLORENCE JAMESON
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 702-262-9676