MEDICARE: MRS. MIKI TON

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	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	NV20212230488	NV

General Provider Information

NPI Number	:	1063184935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MIKI TON

Provider Business Mailing Address
First Line	:	3885 S DECATUR BLVD STE 2000A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3885 S DECATUR BLVD STE 2000A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5873
Country	:	US
Telephone Number	:	702-613-8842
Fax Number	:

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

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	09/29/2021

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Directions to “ MRS. MIKI TON ” Practice Location

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