Provider Demographics
NPI:1164489480
Name:GARBER, JASON E (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:E
Last Name:GARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 S DURANGO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-9186
Mailing Address - Country:US
Mailing Address - Phone:702-835-0088
Mailing Address - Fax:702-826-3162
Practice Address - Street 1:3012 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-9186
Practice Address - Country:US
Practice Address - Phone:702-835-0088
Practice Address - Fax:702-826-3162
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31604207T00000X
UT5420789-1205207T00000X
NV10131207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV140007736OtherRAILROAD MEDICARE
NV2018633Medicaid
AZ648537Medicaid
NV140007736OtherRAILROAD MEDICARE
NV2018633Medicaid
NVH25467Medicare UPIN
AZ648537Medicaid