Basic Information
| Provider Information | |||||||||
| NPI: | 1922371780 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDSCHOOL ASSOCIATES SOUTH | ||||||||
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| OtherOrganizationName: | WOMEN'S HEALTHCARE CENTER OF LAS VEGAS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2040 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712395 | ||||||||
| FaxNumber: | 7023825388 | ||||||||
| Practice Location | |||||||||
| Address1: | 2231 W. CHARLESTON BLVD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029442805 | ||||||||
| FaxNumber: | 7023660466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2012 | ||||||||
| LastUpdateDate: | 02/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | ZAMBONI | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7026712222 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNIVERSITY OF NEVADA SCHOOL OF MEDEICINE MULTISPECIALTY GROUP P | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.