| Ion Alexie, Inc | |
|
2435 Fire Mesa St Suite 120 Las Vegas NV 89128-9009 | |
| (702) 968-2437 | |
| (702) 479-1796 |
| Full Name | Ion Alexie, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2435 Fire Mesa St, Las Vegas, Nevada |
| Authorized Official Name and Position | Ion Alexie (OWNER) |
| Authorized Official Contact | 7028846826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ion Alexie, Inc Po Box 80783 Las Vegas NV 89180-0783 Ph: (702) 228-5800 | Ion Alexie, Inc 2435 Fire Mesa St Suite 120 Las Vegas NV 89128-9009 Ph: (702) 968-2437 |
| NPI Number | 1548479397 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 07/22/2024 |
| Medicare PECOS PAC ID | 4688650757 |
|---|---|
| Medicare Enrollment ID | O20040629000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548479397 | NPI | - | NPPES |
| 100501291 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 7961 (Nevada) | Primary |
| Provider Name | Ion Alexie |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881621662 PECOS PAC ID: 4587626882 Enrollment ID: I20041104000930 |
| Provider Name | Judith L Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467987487 PECOS PAC ID: 5799056388 Enrollment ID: I20170731002635 |
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