Provider Demographics
NPI:1346329851
Name:JIMENEZ, FRANCIS ESCOLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:ESCOLIN
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2810 W CHARLESTON BLVD
Mailing Address - Street 2:STE 47
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1960
Mailing Address - Country:US
Mailing Address - Phone:702-258-4469
Mailing Address - Fax:702-259-0239
Practice Address - Street 1:3009 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1943
Practice Address - Country:US
Practice Address - Phone:702-258-4469
Practice Address - Fax:702-259-0239
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV880504273OtherTAX IDENTIFICATION NUMBER
NV002018621Medicaid
NVNV9268OtherSTATE LICENSE
NV002018621Medicaid
NV880504273OtherTAX IDENTIFICATION NUMBER