| Southern Nevada Internists | |
|
4409 S Pecos Rd Las Vegas NV 89121-5029 | |
| (702) 434-6336 | |
| (702) 436-7912 |
| Full Name | Southern Nevada Internists |
|---|---|
| Speciality | Internal Medicine |
| Location | 4409 S Pecos Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Brian E Lee (PRESIDENT) |
| Authorized Official Contact | 7024346336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Nevada Internists Po Box 621406 Las Vegas NV 89162-1406 Ph: (702) 434-6336 | Southern Nevada Internists 4409 S Pecos Rd Las Vegas NV 89121-5029 Ph: (702) 434-6336 |
| NPI Number | 1982818076 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 04/19/2011 |
| Medicare PECOS PAC ID | 6800989666 |
|---|---|
| Medicare Enrollment ID | O20070910000905 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982818076 | NPI | - | NPPES |
| 100512872 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 12072 (Nevada) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | Brian E Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881768596 PECOS PAC ID: 2860584323 Enrollment ID: I20070828001049 |
| Provider Name | George Duy Linh Thomson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588353239 PECOS PAC ID: 6901253830 Enrollment ID: I20231114001386 |
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