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General NPI Number Information
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NPI Number | 1639209885
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Entity Type | Organization
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Legal Business Name | CURTIS BAZEMORE MD LTD
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6525 N BUFFALO DR SUITE 130
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City | LAS VEGAS
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State | NV
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Zip | 89131-4040
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Country | US
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Telephone | 702-313-7878
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Fax | 702-313-7879
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Provider Business Mailing Address
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Address Line | 6525 N BUFFALO DR SUITE 130
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City | LAS VEGAS
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State | NV
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Zip | 89131-4040
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Country | US
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Telephone | 702-313-7878
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Fax | 702-313-7879
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Authorized Official
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Title or Position | PRESIDENT
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Name | CURTIS E BAZEMORE
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Credential | M.D.
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Telephone | 702-313-7878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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