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NPI Code Detail

MEDICARE: COPPEL SURGICAL SOLUTIONS

MEDICARE: COPPEL SURGICAL SOLUTIONS
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
1261QA1903XAmbulatory Surgical Clinic/Center8322ASC-0NV

General Provider Information

NPI Number : 1386004018
Entity Type Code : Organization
Provider Name (Legal Business Name) : COPPEL SURGICAL SOLUTIONS
Provider Business Mailing Address
First Line : 2809 W CHARLESTON BLVD
Second Line : STE 100
City : LAS VEGAS
State : NV
Zip : 89102-1998
Country : US
Telephone Number : 702-476-1800
Fax Number : 702-476-9500
Provider Business Practice Location Address
First Line : 1569 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5321
Country : US
Telephone Number : 702-476-1800
Fax Number : 702-476-9500
Authorized Official
Title or Position : OFFICER AND AUTHORIZED OFFICIAL
Name : JENNIFER BOYD BALDOCK
Credential :
Telephone Number : 615-234-5954
Provider Enumeration Date : 02/23/2016
Last Update Date : 01/04/2024

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Directions to “COPPEL SURGICAL SOLUTIONS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.