Provider Demographics
NPI:1003298415
Name:RENO ORTHOPAEDIC CLINIC, LTD
Entity Type:Organization
Organization Name:RENO ORTHOPAEDIC CLINIC, LTD
Other - Org Name:RENO ORTHOPEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-786-3040
Mailing Address - Street 1:555 N ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4723
Mailing Address - Country:US
Mailing Address - Phone:775-786-3040
Mailing Address - Fax:775-786-1887
Practice Address - Street 1:5070 ION DR STE 100
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-1654
Practice Address - Country:US
Practice Address - Phone:775-786-3040
Practice Address - Fax:775-786-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11539207X00000X
NV4786207X00000X
NV5168207X00000X
NV14874207XX0005X
NV578363A00000X
NV629363A00000X
NV926363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty