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NPI Code Detail

MEDICARE: STEPHEN A GEPHARDT MD LTD

MEDICARE: STEPHEN A GEPHARDT MD LTD
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
1207LP2900XPain Medicine (Anesthesiology) Physician4992NV

General Provider Information

NPI Number : 1376925016
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPHEN A GEPHARDT MD LTD
Provider Business Mailing Address
First Line : 7220 S CIMARRON RD STE 270
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2160
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7220 S CIMARRON RD STE 270
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2160
Country : US
Telephone Number : 702-912-4100
Fax Number : 702-912-4101
Authorized Official
Title or Position : MD/OWNER
Name : STEPHEN GEPHARDT
Credential :
Telephone Number : 702-912-4100
Provider Enumeration Date : 06/18/2015
Last Update Date : 08/16/2021

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