MEDICARE: NEVADA HOSPITALIST GROUP LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1770812877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA HOSPITALIST GROUP LLP

Provider Business Mailing Address
First Line	:	500 N RAINBOW BLVD
Second Line	:	SUITE #300
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1082
Country	:	US
Telephone Number	:	702-450-1717
Fax Number	:	702-947-6740

Provider Business Practice Location Address
First Line	:	6970 W PATRICK LN
Second Line	:	SUITE #140
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-0269
Country	:	US
Telephone Number	:	702-450-1717
Fax Number	:	702-947-6740

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KIM KOZLOWSKI
Credential	:
Telephone Number	:	702-450-1717

Provider Enumeration Date	:	12/18/2009
Last Update Date	:	09/10/2013

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