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General NPI Number Information
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NPI Number | 1487481537
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Entity Type | Organization
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Legal Business Name | HEALTHY ORGAN ADVANCED PRACTICE PLLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 2801 S VALLEY VIEW BLVD STE 4
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City | LAS VEGAS
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State | NV
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Zip | 89102-0116
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Country | US
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Telephone | 702-602-2610
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 S VALLEY VIEW BLVD STE 4
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City | LAS VEGAS
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State | NV
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Zip | 89102-0116
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Country | US
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Telephone | 702-602-2610
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MR. WILLIAM ALEXANDER MACARAIG-ORGAN
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Credential | FNP-BC
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Telephone | 702-602-2610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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