Provider Demographics
NPI:1033476023
Name:EVENSEN AND TRIPPI MENS HEALTH PLLC
Entity Type:Organization
Organization Name:EVENSEN AND TRIPPI MENS HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:EVENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-778-5900
Mailing Address - Street 1:9499 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE: 270
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7150
Mailing Address - Country:US
Mailing Address - Phone:702-778-5900
Mailing Address - Fax:702-778-5901
Practice Address - Street 1:9499 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7150
Practice Address - Country:US
Practice Address - Phone:702-778-5900
Practice Address - Fax:702-778-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty