Jacob Riis, MD | |
4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | |
(702) 653-2273 | |
Not Available |
Full Name | Jacob Riis |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 4700 Las Vegas Blvd N, Nellis Afb, Nevada |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043417611 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 69060 (Arizona) | Secondary |
207X00000X | Orthopaedic Surgery | ME 103069 (Florida) | Primary |
Entity Name | Kingman Healthcare Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265423917 PECOS PAC ID: 6901791367 Enrollment ID: O20040216001173 |
Mailing Address | Practice Location Address |
---|---|
Jacob Riis, MD 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 Ph: (702) 653-2273 | Jacob Riis, MD 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 Ph: (702) 653-2273 |
Kartik Shenoy, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3040 | |
Dr. Brandon Mark Bennett, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-652-2273 | |
Andrew Haus, Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-2273 | |
Dr. Colin D Kennedy, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3040 | |
Fortune Egbulefu, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3040 | |
Mark A Erickson, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3040 Fax: 702-653-2115 |