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1659189363 NPI number — CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS INC

NPI Number: 1659189363
Health Care Provider/Practitioner: CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS INC

Information about “1659189363” NPI (CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS INC) exists in 1659189363 in HTML format HTML  |  1659189363 in plain Text format TXT  |  1659189363 in PDF (Portable Document Format) PDF  |  1659189363 in an XML format XML  formats.

NPI Number : 1659189363 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659189363",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS INC",
    "ParentOrgTIN": null,
    "OrgName": "CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3495 BUCKHEAD LOOP NE # 19018",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ATLANTA",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30326-1528",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "780 CANTON RD NE STE 330",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MARIETTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30060-7289",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-387-0080",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/27/2024",
    "LastUpdateDate": "12/27/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CAMPBELL",
    "AuthorizedOfficialFirstName": "NEVILLE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD/MBA",
    "AuthorizedOfficialTelephoneNumber": "702-476-9700",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP3300X",
        "TaxonomyName": "Pain Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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