Provider Demographics
NPI:1114274057
Name:ANTFLICK, ADAM JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:ANTFLICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3157 N RAINBOW BLVD
Mailing Address - Street 2:# 518
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4578
Mailing Address - Country:US
Mailing Address - Phone:702-386-4700
Mailing Address - Fax:702-386-4701
Practice Address - Street 1:7220 S CIMARRON RD STE 270
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2160
Practice Address - Country:US
Practice Address - Phone:702-386-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV56552207LP2900X
NVDO2196208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine