Healthcare Provider Details

I. General information

NPI: 1407811417
Provider Name (Legal Business Name): LAS VEGAS NEUROSURGERY ORTHOPAEDICS AND REHABILITATION LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S RANCHO DR SUITE I67
LAS VEGAS NV
89106-4862
US

IV. Provider business mailing address

501 S RANCHO DR SUITE I67
LAS VEGAS NV
89106-4862
US

V. Phone/Fax

Practice location:
  • Phone: 702-243-4700
  • Fax: 702-243-7074
Mailing address:
  • Phone: 702-243-4700
  • Fax: 702-243-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ARLEEN H FERRARIS
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 702-243-4700