MEDICARE: NEVADA SURGICAL SPECIALISTS LLC

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	174400000X	Specialist	G2126	TX
2	174400000X	Specialist	05906R	LA
3	174400000X	Specialist	NV5503	NV
4	207XS0106X	Orthopaedic Hand Surgery Physician	5503	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01240039	OTHER	NV	AMERIGROUP

General Provider Information

NPI Number	:	1437331014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA SURGICAL SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	3570 E FLAMINGO ROAD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5000
Country	:	US
Telephone Number	:	702-454-3400
Fax Number	:	702-454-7185

Provider Business Practice Location Address
First Line	:	3570 E FLAMINGO ROAD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5000
Country	:	US
Telephone Number	:	702-454-3400
Fax Number	:	702-454-7185

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. LARRY D. DENNY
Credential	:	M.D.
Telephone Number	:	702-254-3939

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	05/17/2012

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Directions to “NEVADA SURGICAL SPECIALISTS LLC ” Practice Location

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