Basic Information
| Provider Information | |||||||||
| NPI: | 1063458594 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT B. MCBEATH MD PROFESSIONAL CORPORATION | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | UROLOGY SPECIALISTS OF NEVADA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 35380 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891335380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025793253 | ||||||||
| FaxNumber: | 7023047451 | ||||||||
| Practice Location | |||||||||
| Address1: | 3150 N TENAYA WAY | ||||||||
| Address2: | 165 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028770814 | ||||||||
| FaxNumber: | 7028773238 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 04/21/2015 | ||||||||
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| AuthorizedOfficialLastName: | MCBEATH | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7028770814 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.