MEDICARE: THOMAS R LAND MD 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
1	207Q00000X	Family Medicine Physician	11546	NV

General Provider Information

NPI Number	:	1982840955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS R LAND MD PC

Provider Business Mailing Address
First Line	:	3022 S DURANGO DR
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4440
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5945 S RAINBOW BLVD
Second Line	:	#140
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2559
Country	:	US
Telephone Number	:	702-256-3637
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS R LAND
Credential	:	MD
Telephone Number	:	702-343-4330

Provider Enumeration Date	:	12/22/2008
Last Update Date	:	04/30/2009

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