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NPI Code Detail

MEDICARE: KID DOCTORS URGENT CARE

MEDICARE: KID DOCTORS URGENT CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PP0204XPediatric Emergency Medicine (Emergency Medicine) Physician2081NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033384896
Entity Type Code : Organization
Provider Name (Legal Business Name) : KID DOCTORS URGENT CARE
Provider Business Mailing Address
First Line : 4840 S FORT APACHE ROAD
Second Line : 101
City : LAS VEGAS
State : NV
Zip : 89147-7949
Country : US
Telephone Number : 702-254-5437
Fax Number : 702-367-1698
Provider Business Practice Location Address
First Line : 4840 S FORT APACHE
Second Line : 101
City : LAS VEGAS
State : NV
Zip : 89147-7949
Country : US
Telephone Number : 702-254-5437
Fax Number : 702-367-1698
Authorized Official
Title or Position : OWNER
Name : DR. ERIC DEURELL
Credential : MD
Telephone Number : 702-450-5437
Provider Enumeration Date : 04/23/2008
Last Update Date : 04/23/2008

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Directions to “KID DOCTORS URGENT CARE ” Practice Location

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