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General NPI Number Information
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NPI Number | 1538708573
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Entity Type | Organization
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Legal Business Name | SKIN DOCS
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Dates
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Enumeration Date | 12/21/2019
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 2860 E DESERT INN RD
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City | LAS VEGAS
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State | NV
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Zip | 89121-3605
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Country | US
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Telephone | 702-551-9487
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Fax | 702-924-0634
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Provider Business Mailing Address
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Address Line | 410 S RANCHO DR
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City | LAS VEGAS
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State | NV
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Zip | 89106-4802
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Country | US
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Telephone | 702-349-9001
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Fax |
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Authorized Official
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Title or Position | DERMATOLOGIST
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Name | DR. JONATHAN BELLEW
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Credential | DO
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Telephone | 702-349-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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