Provider Demographics
NPI:1225122260
Name:SPOON, BARTHOLOMEW, & BOYD APC
Entity Type:Organization
Organization Name:SPOON, BARTHOLOMEW, & BOYD APC
Other - Org Name:LAS VEGAS OB/GYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHELLE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GIANNINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-382-2900
Mailing Address - Street 1:2010 GOLDRING AVE
Mailing Address - Street 2:200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4002
Mailing Address - Country:US
Mailing Address - Phone:702-382-2900
Mailing Address - Fax:702-382-1980
Practice Address - Street 1:2010 GOLDRING AVE
Practice Address - Street 2:200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4002
Practice Address - Country:US
Practice Address - Phone:702-382-2900
Practice Address - Fax:702-382-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWJBLFMedicare ID - Type Unspecified