MEDICARE: DR. JALDEEP H DAULAT 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	207ND0101X	MOHS-Micrographic Surgery Physician	363	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070003254	OTHER	NV	RAILROAD MEDICARE
3	070012029	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1114949492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JALDEEP H DAULAT DO

Provider Business Mailing Address
First Line	:	9750 W SKYE CANYON PARK DR
Second Line	:	SUITE 160 BOX 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89166
Country	:	US
Telephone Number	:	702-683-1727
Fax Number	:	702-974-0440

Provider Business Practice Location Address
First Line	:	3975 S DURANGO DR STE 107
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-4156
Country	:	US
Telephone Number	:	702-628-5333
Fax Number	:	702-974-0440

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/11/2023

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Directions to “ DR. JALDEEP H DAULAT DO” Practice Location

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