Provider Demographics
NPI:1619388683
Name:SIERRA NEVADA SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:SIERRA NEVADA SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:KNOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-546-3194
Mailing Address - Street 1:PO BOX 4237
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-4237
Mailing Address - Country:US
Mailing Address - Phone:775-461-2997
Mailing Address - Fax:775-461-2998
Practice Address - Street 1:2874 N CARSON ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0251
Practice Address - Country:US
Practice Address - Phone:775-461-2997
Practice Address - Fax:775-461-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty