Provider Demographics
NPI:1578508065
Name:MOUNTAIN REHABILITATION SERVICES POINDEXTER & ASSOCIATES LTD
Entity Type:Organization
Organization Name:MOUNTAIN REHABILITATION SERVICES POINDEXTER & ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:POINDEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-732-8558
Mailing Address - Street 1:PO BOX 34570
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4570
Mailing Address - Country:US
Mailing Address - Phone:702-732-8558
Mailing Address - Fax:702-732-8568
Practice Address - Street 1:2641 BOX CANYON DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0419
Practice Address - Country:US
Practice Address - Phone:702-732-8558
Practice Address - Fax:702-732-8568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV63342081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019154Medicaid
NVVWQBCSMedicare PIN
NVE13878Medicare UPIN