Provider Demographics
NPI:1619933322
Name:TAUSCH, GILBERT STEPHAN (MD)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:STEPHAN
Last Name:TAUSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7751 W FLAMINGO RD
Mailing Address - Street 2:STE A100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-5401
Mailing Address - Country:US
Mailing Address - Phone:702-804-6555
Mailing Address - Fax:702-804-1273
Practice Address - Street 1:7751 W FLAMINGO RD
Practice Address - Street 2:STE. A100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-5401
Practice Address - Country:US
Practice Address - Phone:702-804-6555
Practice Address - Fax:702-804-1273
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043812E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA154061JFXMedicare ID - Type Unspecified
PAA37732Medicare UPIN