Dodge A Slagle Do Ltd | |
1090 Wigwam Parkway Suite 100 Henderson NV 89074 | |
(702) 454-0201 | |
(702) 454-1245 |
Full Name | Dodge A Slagle Do Ltd |
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Speciality | Psychiatry & Neurology |
Location | 1090 Wigwam Parkway, Henderson, Nevada |
Authorized Official Name and Position | Debra Ellen Quinn (BILLING MANAGER) |
Authorized Official Contact | 7024540201 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dodge A Slagle Do Ltd 1090 Wigwam Parkway Suite 100 Henderson NV 89074 Ph: (702) 454-0201 | Dodge A Slagle Do Ltd 1090 Wigwam Parkway Suite 100 Henderson NV 89074 Ph: (702) 454-0201 |
NPI Number | 1568669547 |
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Provider Enumeration Date | 07/02/2007 |
Last Update Date | 11/30/2007 |
Medicare PECOS PAC ID | 6800996059 |
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Medicare Enrollment ID | O20070717000475 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568669547 | NPI | - | NPPES |
002002729 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 500 (Nevada) | Primary |
Provider Name | Dodge A Slagle |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1578570578 PECOS PAC ID: 2769589951 Enrollment ID: I20070523000256 |
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