MEDICARE: RICHARD ROTHMAN 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	207W00000X	Ophthalmology Physician	9323	NV

General Provider Information

NPI Number	:	1649603598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ROTHMAN MD

Provider Business Mailing Address
First Line	:	8190 S MARYLAND PKWY
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4100
Country	:	US
Telephone Number	:	702-636-2010
Fax Number	:	702-362-2011

Provider Business Practice Location Address
First Line	:	8190 S MARYLAND PKWY
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4100
Country	:	US
Telephone Number	:	702-636-2010
Fax Number	:	702-362-2011

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

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	08/14/2013

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