MEDICARE: DR. PATRICK EDWARD JANIK DO

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	2084P0800X	Psychiatry Physician	DO3588	NV

General Provider Information

NPI Number	:	1063078830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK EDWARD JANIK DO

Provider Business Mailing Address
First Line	:	6415 S FORT APACHE RD STE 1851004
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-6744
Country	:	US
Telephone Number	:	702-530-7069
Fax Number	:

Provider Business Practice Location Address
First Line	:	6415 S FORT APACHE RD STE 1851004
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-6744
Country	:	US
Telephone Number	:	702-530-7069
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	05/20/2025

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