MEDICARE: MARK OHRINER OD LTD

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
1	152W00000X	Optometrist	0249	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1043244767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK OHRINER OD LTD

Provider Business Mailing Address
First Line	:	4675 W FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3701
Country	:	US
Telephone Number	:	702-364-1252
Fax Number	:	702-364-9716

Provider Business Practice Location Address
First Line	:	4675 W FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3701
Country	:	US
Telephone Number	:	702-364-1252
Fax Number	:	702-364-9716

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	JASMINE MILLS
Credential	:
Telephone Number	:	702-364-1252

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/05/2021

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