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General NPI Number Information
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NPI Number | 1235314725
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Entity Type | Organization
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Legal Business Name | JENNY A VAN DUYNE MD LTD
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 9770 S MCCARRAN BLVD
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 775-322-4589
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Fax | 775-322-3787
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Provider Business Mailing Address
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Address Line | 9770 S MCCARREN BLVD
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 775-322-4589
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Fax | 775-322-3787
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | JENNY A VAN DUYNE
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Credential | MD
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Telephone | 775-322-4589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | 9031
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 9031
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License Number State | NV
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