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NPI Code Detail

MEDICARE: GARY L KANTOR M.D.

MEDICARE: GARY L KANTOR M.D.
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
1207RN0300XNephrology Physician2607NV

General Provider Information

NPI Number : 1962483073
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY L KANTOR M.D.
Provider Business Mailing Address
First Line : 1750 E DESERT INN RD
Second Line : #200
City : LAS VEGAS
State : NV
Zip : 89109-3202
Country : US
Telephone Number : 702-732-2438
Fax Number : 702-734-7006
Provider Business Practice Location Address
First Line : 1750 E DESERT INN RD
Second Line : #200
City : LAS VEGAS
State : NV
Zip : 89109-3202
Country : US
Telephone Number : 702-732-2438
Fax Number : 702-734-7006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 07/08/2007

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