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General NPI Number Information
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NPI Number | 1780280941
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Entity Type | Organization
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Legal Business Name | NOVATIO, PLLC
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 6080 S FORT APACHE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89148-5616
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Country | US
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Telephone | 702-984-7557
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Fax |
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Provider Business Mailing Address
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Address Line | 6080 S FORT APACHE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89148-5616
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Country | US
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Telephone | 702-702-9847
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Fax | 833-989-2328
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | ELENA CROCKETT
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Credential |
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Telephone | 702-984-7557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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