| Desert Gastroenterology Associates | |
|
2625 Wigwam Pkwy Ste 112 Henderson NV 89074-7326 | |
| (702) 255-5900 | |
| (702) 255-5980 |
| Full Name | Desert Gastroenterology Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 2625 Wigwam Pkwy Ste 112, Henderson, Nevada |
| Authorized Official Name and Position | Adedayo O Mokuolu (OWNER) |
| Authorized Official Contact | 7022555900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Gastroenterology Associates 2625 Wigwam Pkwy Ste 112 Henderson NV 89074-7326 Ph: (702) 255-5900 | Desert Gastroenterology Associates 2625 Wigwam Pkwy Ste 112 Henderson NV 89074-7326 Ph: (702) 255-5900 |
| NPI Number | 1801926324 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 09/27/2022 |
| Medicare PECOS PAC ID | 6507842481 |
|---|---|
| Medicare Enrollment ID | O20090519000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801926324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 5306 (Nevada) | Primary |
| Provider Name | Adedayo Olumide Mokuolu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467485409 PECOS PAC ID: 1557348091 Enrollment ID: I20080314000057 |
| Provider Name | Rohtashav Dhir |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881808715 PECOS PAC ID: 4880785997 Enrollment ID: I20210716000709 |
| Provider Name | Natalie Huxtable |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962167585 PECOS PAC ID: 5193102747 Enrollment ID: I20220519002089 |
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