MEDICARE: FLAMINGO PAIN SPECIALISTS LAIRD, PLLC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	7912	NV

General Provider Information

NPI Number	:	1386000586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLAMINGO PAIN SPECIALISTS LAIRD, PLLC

Provider Business Mailing Address
First Line	:	4175 S RILEY ST STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8719
Country	:	US
Telephone Number	:	702-202-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	4175 S RILEY ST STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8719
Country	:	US
Telephone Number	:	702-202-3700
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIAL LAIRD
Credential	:	MD
Telephone Number	:	702-202-3700

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	06/14/2022

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