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General NPI Number Information
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NPI Number | 1225781891
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Entity Type | Organization
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Legal Business Name | SURGERY NEVADA LLC
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 5560 KIETZKE LN
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City | RENO
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State | NV
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Zip | 89511-3019
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Country | US
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Telephone | 775-284-1638
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Fax |
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Provider Business Mailing Address
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Address Line | 5560 KIETZKE LN
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City | RENO
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State | NV
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Zip | 89511-3019
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Country | US
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Telephone | 775-284-1638
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | WILLIAM P. DOUGLAS
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Credential |
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Telephone | 775-284-1643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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