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NPI Code Detail

MEDICARE: DR. WELDON EDWARD HAVINS M.D.

MEDICARE: DR. WELDON EDWARD HAVINS 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
1207W00000XOphthalmology Physician2867NV

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 : 1588653364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WELDON EDWARD HAVINS M.D.
Provider Business Mailing Address
First Line : 1505 WIGWAM PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89074-8195
Country : US
Telephone Number : 702-896-6043
Fax Number : 702-896-9591
Provider Business Practice Location Address
First Line : 1505 WIGWAM PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89074-8195
Country : US
Telephone Number : 702-896-6043
Fax Number : 702-896-9591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 01/03/2024

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