MEDICARE: ROBERT LAWRENCE KINSMAN M.D.

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	207L00000X	Anesthesiology Physician	6028	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	:	1144229139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LAWRENCE KINSMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 35891
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5891
Country	:	US
Telephone Number	:	702-395-1070
Fax Number	:	702-395-1071

Provider Business Practice Location Address
First Line	:	8440 W LAKE MEAD BLVD STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7648
Country	:	US
Telephone Number	:	702-395-1070
Fax Number	:	702-395-1071

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	10/26/2017

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