| Kose Iseh Pllc | |
|
6166 N Durango Dr Las Vegas NV 89149-3912 | |
| (725) 223-4100 | |
| Not Available |
| Full Name | Kose Iseh Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6166 N Durango Dr, Las Vegas, Nevada |
| Authorized Official Name and Position | Mfon Peter Iseh (OWNER OF ENTITY) |
| Authorized Official Contact | 7027689291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kose Iseh Pllc 10470 W Cheyenne Avenue Ste 115, Pmb 311 Las Vegas NV 89129 Ph: (702) 202-4534 | Kose Iseh Pllc 6166 N Durango Dr Las Vegas NV 89149-3912 Ph: (725) 223-4100 |
| NPI Number | 1881203073 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 03/23/2021 |
| Medicare PECOS PAC ID | 5991118333 |
|---|---|
| Medicare Enrollment ID | O20210104002141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881203073 | NPI | - | NPPES |
| Provider Name | Mfon P Iseh |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1407218258 PECOS PAC ID: 1850686593 Enrollment ID: I20191102000245 |
| Provider Name | Faith M Iseh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962002907 PECOS PAC ID: 5092120386 Enrollment ID: I20210218002322 |
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