Healthcare Provider Details

I. General information

NPI: 1225228810
Provider Name (Legal Business Name): JOEL N. LUBRITZ MD CHARTERED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 S MARYLAND PKWY 102
LAS VEGAS NV
89109-2323
US

IV. Provider business mailing address

3101 S MARYLAND PKWY 102
LAS VEGAS NV
89109-2323
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-4491
  • Fax: 702-732-3966
Mailing address:
  • Phone: 702-732-4491
  • Fax: 702-732-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number8547
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number10450
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number8547
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number7859
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number289
License Number StateNV
# 6
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2598
License Number StateNV

VIII. Authorized Official

Name: DR. JOEL N LUBRITZ
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 702-732-4491