MEDICARE: NED S STOUGHTON 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	207N00000X	Dermatology Physician	10960	NV

General Provider Information

NPI Number	:	1205804028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NED S STOUGHTON M.D.

Provider Business Mailing Address
First Line	:	4141 SWENSON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6718
Country	:	US
Telephone Number	:	702-796-3171
Fax Number	:	702-796-3152

Provider Business Practice Location Address
First Line	:	4141 SWENSON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6718
Country	:	US
Telephone Number	:	702-796-3171
Fax Number	:	702-796-3152

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	02/01/2013

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