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NPI Code Detail

MEDICARE: JANICE E EGGERT MD LTD

MEDICARE: JANICE E EGGERT MD LTD
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 Physician
2207WX0200XOphthalmic Plastic and Reconstructive Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2V53859OTHERNVMEDICARE PTAN

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 : 1679839690
Entity Type Code : Organization
Provider Name (Legal Business Name) : JANICE E EGGERT MD LTD
Provider Business Mailing Address
First Line : 1771 E FLAMINGO RD STE 214A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0850
Country : US
Telephone Number : 702-737-5252
Fax Number : 702-737-5960
Provider Business Practice Location Address
First Line : 1771 E FLAMINGO RD STE 214A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0850
Country : US
Telephone Number : 702-737-5252
Fax Number : 702-737-5960
Authorized Official
Title or Position : PRESIDENT
Name : JANICE E EGGERT
Credential : M.D.
Telephone Number : 702-737-5252
Provider Enumeration Date : 04/03/2012
Last Update Date : 02/20/2018

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