Provider Demographics
NPI:1063680247
Name:CHRISTOPHER A. MINOTT, MD, LTD
Entity Type:Organization
Organization Name:CHRISTOPHER A. MINOTT, MD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-384-7234
Mailing Address - Street 1:501 S RANCHO DR
Mailing Address - Street 2:SUITE G44
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4828
Mailing Address - Country:US
Mailing Address - Phone:702-384-7234
Mailing Address - Fax:702-384-3150
Practice Address - Street 1:501 S RANCHO DR
Practice Address - Street 2:SUITE G44
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4828
Practice Address - Country:US
Practice Address - Phone:702-384-7234
Practice Address - Fax:702-384-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5541208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC96362Medicare UPIN
NVV30435Medicare PIN