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General NPI Number Information
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NPI Number | 1962119941
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Entity Type | Organization
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Legal Business Name | OPENSIDED MRI OF LAS VEGAS, LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 3175 SAINT ROSE PKWY STE 130
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City | HENDERSON
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State | NV
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Zip | 89052-3507
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Country | US
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Telephone | 702-932-2740
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Fax | 702-932-2739
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Provider Business Mailing Address
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Address Line | 600 S RANCHO DR STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89106-4806
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Country | US
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Telephone | 702-932-2740
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Fax | 702-932-2739
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | JOHN STEVEN PLATUSIC
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Credential |
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Telephone | 804-363-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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