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General NPI Number Information
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NPI Number | 1558618710
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Entity Type | Organization
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Legal Business Name | MARVIN D SPANN MD PLLC
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 9950 W FLAMINGO RD STE 105
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City | LAS VEGAS
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State | NV
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Zip | 89147-8555
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Country | US
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Telephone | 702-998-9001
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Fax | 702-998-8282
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Provider Business Mailing Address
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Address Line | PO BOX 35914
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City | LAS VEGAS
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State | NV
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Zip | 89133-5914
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Country | US
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Telephone | 702-998-9001
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Fax | 702-998-8282
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Authorized Official
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Title or Position | OWNER
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Name | MARVIN DOUGLAS SPANN
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Credential | M.D.
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Telephone | 702-998-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 13247
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 13132
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License Number State | NV
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