Healthcare Provider Details

I. General information

NPI: 1770665002
Provider Name (Legal Business Name): LAS VEGAS NEUROSURGERY & SPINE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8285 W ARBY AVE STE 220
LAS VEGAS NV
89113-2236
US

IV. Provider business mailing address

8285 W ARBY AVE STE 220
LAS VEGAS NV
89113-2236
US

V. Phone/Fax

Practice location:
  • Phone: 702-737-7753
  • Fax: 702-407-7066
Mailing address:
  • Phone: 702-737-7753
  • Fax: 702-407-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number7950
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number10718
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number6485
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number6355
License Number StateNV

VIII. Authorized Official

Name: DAWN MARIE BROWN
Title or Position: OFFICE MANAGER
Credential:
Phone: 702-737-7753