Desert Gastroenterology Associates | |
2625 Wigwam Pkwy Ste 112 Henderson NV 89074-7326 | |
(702) 255-5900 | |
(702) 255-5980 |
Full Name | Desert Gastroenterology Associates |
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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 |
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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 |
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Provider Enumeration Date | 03/06/2007 |
Last Update Date | 09/27/2022 |
Medicare PECOS PAC ID | 6507842481 |
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Medicare Enrollment ID | O20090519000325 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801926324 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | 5306 (Nevada) | Primary |
Provider Name | Adedayo Olumide Mokuolu |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1467485409 PECOS PAC ID: 1557348091 Enrollment ID: I20080314000057 |
Provider Name | Rohtashav Dhir |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1881808715 PECOS PAC ID: 4880785997 Enrollment ID: I20210716000709 |
Provider Name | Natalie Huxtable |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962167585 PECOS PAC ID: 5193102747 Enrollment ID: I20220519002089 |
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