Provider Demographics
NPI:1376967091
Name:PADGETT, MATTHEW (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:PADGETT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 SAINT ROSE PKWY
Mailing Address - Street 2:150
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4843
Mailing Address - Country:US
Mailing Address - Phone:702-248-7337
Mailing Address - Fax:702-478-5465
Practice Address - Street 1:2847 SAINT ROSE PKWY
Practice Address - Street 2:150
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4843
Practice Address - Country:US
Practice Address - Phone:702-248-7337
Practice Address - Fax:702-478-5465
Is Sole Proprietor?:No
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA1519363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical