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General NPI Number Information
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NPI Number | 1992058192
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Entity Type | Organization
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Legal Business Name | EDWARD C SPOON JR MD LTD
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 2010 GOLDRING AVE 200
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City | LAS VEGAS
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State | NV
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Zip | 89106-4002
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Country | US
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Telephone | 702-382-2900
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Fax | 702-382-1980
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Provider Business Mailing Address
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Address Line | 2010 GOLDRING AVE 200
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City | LAS VEGAS
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State | NV
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Zip | 89106-4002
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Country | US
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Telephone | 702-382-2900
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Fax | 702-382-1980
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD CAREY SPOON JR.
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Credential | MD
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Telephone | 702-382-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 6595
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License Number State | NV
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