MEDICARE: DR. JON L SIEMS M.D.

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	9250	NV
2	207W00000X	Ophthalmology Physician	9250	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

General Provider Information

NPI Number	:	1528068640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON L SIEMS M.D.

Provider Business Mailing Address
First Line	:	3810 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6227
Country	:	US
Telephone Number	:	702-948-2010
Fax Number	:	702-920-8787

Provider Business Practice Location Address
First Line	:	3810 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6227
Country	:	US
Telephone Number	:	702-948-2010
Fax Number	:	702-920-8787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/14/2024

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