MEDICARE: DR. SHAILY JAIN 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
1	2084P0800X	Psychiatry Physician	12000	NV

General Provider Information

NPI Number	:	1568542934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAILY JAIN MD

Provider Business Mailing Address
First Line	:	2700 ASHBY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2135
Country	:	US
Telephone Number	:	702-508-9461
Fax Number	:	702-508-9461

Provider Business Practice Location Address
First Line	:	3615 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1842
Country	:	US
Telephone Number	:	702-508-9461
Fax Number	:	702-508-9461

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	03/20/2012

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