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NPI Code Detail

MEDICARE: JEFFREY JUDE TORDILLA MD

MEDICARE:   JEFFREY JUDE TORDILLA  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
1207L00000XAnesthesiology Physician12344NV

Other Identifiers

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

General Provider Information

NPI Number : 1407058050
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY JUDE TORDILLA MD
Provider Business Mailing Address
First Line : JEFFREY TORDILLA MD
Second Line : PO BOX 93358
City : LAS VEGAS
State : NV
Zip : 89193-3358
Country : US
Telephone Number : 702-487-6510
Fax Number : 702-405-7960
Provider Business Practice Location Address
First Line : ALPINE ANESTHESIA
Second Line : 6402 MCLEOD DR SUTE 2
City : LAS VEGAS
State : NV
Zip : 89120
Country : US
Telephone Number : 702-487-6510
Fax Number : 702-405-7960
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2007
Last Update Date : 04/09/2024

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