Lucas Nathan Vine, PA- C | |
276 Kingsbury Grade Ste 101, Stateline, NV 89449-9804 | |
(775) 588-5000 | |
Not Available |
Full Name | Lucas Nathan Vine |
---|---|
Gender | Male |
Speciality | Dermatology |
Location | 276 Kingsbury Grade Ste 101, Stateline, Nevada |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942001474 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | PA3176 (Nevada) | Primary |
Mailing Address | Practice Location Address |
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Lucas Nathan Vine, PA- C 276 Kingsbury Grade Ste 101, Stateline, NV 89449-9804 Ph: (775) 588-5000 | Lucas Nathan Vine, PA- C 276 Kingsbury Grade Ste 101, Stateline, NV 89449-9804 Ph: (775) 588-5000 |
Martin Ernst Salm, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 276 Kingsbury Grade, Suite 101, Stateline, NV 89449 Phone: 775-588-5000 Fax: 775-588-5001 | |
Dr. Benjamin Daniel Bradford, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 276 Kingsbury Grade # 101, Stateline, NV 89449 Phone: 775-588-5000 |