Provider Demographics
NPI:1518114529
Name:WELDON E HAVINS M D LTD
Entity Type:Organization
Organization Name:WELDON E HAVINS M D LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WELDON
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAVINS
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:702-362-3937
Mailing Address - Street 1:2575 LINDELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5409
Mailing Address - Country:US
Mailing Address - Phone:702-362-3937
Mailing Address - Fax:702-362-7935
Practice Address - Street 1:2575 LINDELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5409
Practice Address - Country:US
Practice Address - Phone:702-362-3937
Practice Address - Fax:702-362-7935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2867207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C35919Medicare UPIN
NVCD015AMedicare PIN