Provider Demographics
NPI:1073853156
Name:NAOMI CHANEY M D LTD
Entity Type:Organization
Organization Name:NAOMI CHANEY M D LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:702-319-5900
Mailing Address - Street 1:5380 S RAINBOW BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1879
Mailing Address - Country:US
Mailing Address - Phone:702-319-5900
Mailing Address - Fax:702-319-5901
Practice Address - Street 1:5380 S RAINBOW BLVD STE 218
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1879
Practice Address - Country:US
Practice Address - Phone:702-319-5900
Practice Address - Fax:702-319-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty