Basic Information
| Provider Information | |||||||||
| NPI: | 1548247281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CORNETT | ||||||||
| FirstName: | FRANK | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3157 N RAINBOW BLVD # 518 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891084578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023864700 | ||||||||
| FaxNumber: | 7023864701 | ||||||||
| Practice Location | |||||||||
| Address1: | 7250 PEAK DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891289028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023864700 | ||||||||
| FaxNumber: | 7023864701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 6439 | NV | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 100503151 | 05 | NV | MEDICAID |