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General NPI Number Information
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NPI Number | 1750734067
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Entity Type | Organization
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Legal Business Name | DARREN E WIRTZ & ASSOCIATES
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Dates
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Enumeration Date | 07/21/2016
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 7180 CASCADE VALLEY CT STE 280
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City | LAS VEGAS
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State | NV
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Zip | 89128-0449
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Country | US
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Telephone | 702-510-4508
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Fax |
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Provider Business Mailing Address
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Address Line | 7180 CASCADE VALLEY CT STE 280
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City | LAS VEGAS
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State | NV
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Zip | 89128-0481
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Country | US
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Telephone | 702-510-4508
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARREN E WIRTZ
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Credential | DO
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Telephone | 702-510-4508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DO1466
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License Number State | NV
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