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NPI Code Detail

MEDICARE: BRENT FREDERICK BARTHOLOMEW MD

MEDICARE:   BRENT FREDERICK BARTHOLOMEW  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
1207V00000XObstetrics & Gynecology Physician6911NV

General Provider Information

NPI Number : 1568464097
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENT FREDERICK BARTHOLOMEW MD
Provider Business Mailing Address
First Line : 8906 SPANISH RIDGE AVE STE 202
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1319
Country : US
Telephone Number : 702-330-3102
Fax Number : 702-912-4994
Provider Business Practice Location Address
First Line : 653 N TOWN CENTER DR STE 317
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-0504
Country : US
Telephone Number : 702-382-2900
Fax Number : 702-382-1980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 11/10/2020

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Directions to “ BRENT FREDERICK BARTHOLOMEW MD” Practice Location

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