Provider Demographics
NPI:1689372989
Name:MAXWELL O. VEST, M.D., PLLC
Entity Type:Organization
Organization Name:MAXWELL O. VEST, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER
Authorized Official - Prefix:
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:OMER
Authorized Official - Last Name:VEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-558-3221
Mailing Address - Street 1:6 FIRE ROCK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-6041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1416 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1231
Practice Address - Country:US
Practice Address - Phone:618-558-3221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty