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NPI Code Detail

MEDICARE: DR. RUSSELL T. NEVINS MD

MEDICARE: DR. RUSSELL T. NEVINS MD
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
1207X00000XOrthopaedic Surgery Physician10441NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306845649
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUSSELL T. NEVINS MD
Provider Business Mailing Address
First Line : 2800 E DESERT INN RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3609
Country : US
Telephone Number : 702-731-1616
Fax Number : 702-734-4900
Provider Business Practice Location Address
First Line : 2800 E DESERT INN RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3609
Country : US
Telephone Number : 702-731-1616
Fax Number : 702-734-4900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 04/02/2019

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Directions to “ DR. RUSSELL T. NEVINS MD” Practice Location

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