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General NPI Number Information
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NPI Number | 1568542934
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Entity Type | Individual
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Provider Name | SHAILY JAIN MD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 3615 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-1842
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Country | US
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Telephone | 702-508-9461
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Fax | 702-508-9461
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Provider Business Mailing Address
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Address Line | 2700 ASHBY AVE
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City | LAS VEGAS
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State | NV
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Zip | 89102-2135
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Country | US
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Telephone | 702-508-9461
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Fax | 702-508-9461
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 12000
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License Number State | NV
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