MEDICARE: DR. PATRICK S. MCNULTY 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	207X00000X	Orthopaedic Surgery Physician	8238	NV
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	8238	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922007244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK S. MCNULTY MD

Provider Business Mailing Address
First Line	:	3012 S DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-9186
Country	:	US
Telephone Number	:	702-835-0088
Fax Number	:	702-826-3162

Provider Business Practice Location Address
First Line	:	3175 SAINT ROSE PKWY STE 320
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3508
Country	:	US
Telephone Number	:	702-463-1424
Fax Number	:	702-901-4112

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	09/21/2022

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