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NPI Code Detail

MEDICARE: GIRISGEN & KOPOLOW OD, PC

MEDICARE: GIRISGEN & KOPOLOW OD, PC
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
1152W00000XOptometrist323NV

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 : 1841523164
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIRISGEN & KOPOLOW OD, PC
Provider Business Mailing Address
First Line : 7361 W LAKE MEAD BLVD STE 104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1040
Country : US
Telephone Number : 702-733-6764
Fax Number : 702-255-5795
Provider Business Practice Location Address
First Line : 2021 N RAINBOW BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-7098
Country : US
Telephone Number : 702-733-6764
Fax Number : 702-255-5795
Authorized Official
Title or Position : OWNER
Name : DR. SEFIR T GIRISGEN
Credential : OD
Telephone Number : 702-733-6764
Provider Enumeration Date : 09/18/2009
Last Update Date : 09/27/2011

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Directions to “GIRISGEN & KOPOLOW OD, PC ” Practice Location

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