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General NPI Number Information
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NPI Number | 1548847999
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Entity Type | Individual
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Provider Name | JACOB SENKER MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 6350 S DURANGO DR
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City | LAS VEGAS
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State | NV
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Zip | 89113-1774
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Country | US
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Telephone | 702-790-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W ESPLANADE AVE STE 412
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City | KENNER
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State | LA
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Zip | 70065-2475
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25204
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License Number State | NV
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