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NPI Code Detail

MEDICARE: LANCE D MAYOR, MD LTD

MEDICARE: LANCE D MAYOR, 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
1207R00000XInternal Medicine Physician3943NV

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 : 1891098760
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANCE D MAYOR, MD LTD
Provider Business Mailing Address
First Line : 2121 E FLAMINGO RD
Second Line : 202
City : LAS VEGAS
State : NV
Zip : 89119-5122
Country : US
Telephone Number : 702-369-0004
Fax Number : 702-369-6488
Provider Business Practice Location Address
First Line : 2121 E FLAMINGO RD
Second Line : 202
City : LAS VEGAS
State : NV
Zip : 89119-5122
Country : US
Telephone Number : 702-369-0004
Fax Number : 702-369-6488
Authorized Official
Title or Position : OWNER
Name : LANCE D MAYOR
Credential : MD
Telephone Number : 702-369-0004
Provider Enumeration Date : 12/14/2010
Last Update Date : 12/14/2010

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Directions to “LANCE D MAYOR, MD LTD ” Practice Location

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