| Primary Care Of Southern Nevada | |
|
2225 Village Walk Dr Suite 270 Henderson NV 89052-5679 | |
| (702) 993-0333 | |
| (702) 990-0336 |
| Full Name | Primary Care Of Southern Nevada |
|---|---|
| Speciality | Internal Medicine |
| Location | 2225 Village Walk Dr, Henderson, Nevada |
| Authorized Official Name and Position | Kelly Elan Van Wagner (OWNER) |
| Authorized Official Contact | 7029900333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Southern Nevada 2225 Village Walk Dr Suite 270 Henderson NV 89052-5679 Ph: (702) 993-0333 | Primary Care Of Southern Nevada 2225 Village Walk Dr Suite 270 Henderson NV 89052-5679 Ph: (702) 993-0333 |
| NPI Number | 1821026824 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 10/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821026824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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