Provider Demographics
NPI:1801843685
Name:EYE ASSOCIATES OF NEVADA
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF NEVADA
Other - Org Name:WELLISH VISION INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:L
Authorized Official - Last Name:WELLISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:702-733-2020
Mailing Address - Street 1:2110 E FLAMINGO RD
Mailing Address - Street 2:#210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5190
Mailing Address - Country:US
Mailing Address - Phone:702-733-2020
Mailing Address - Fax:702-794-2797
Practice Address - Street 1:2110 E FLAMINGO RD
Practice Address - Street 2:#210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5190
Practice Address - Country:US
Practice Address - Phone:702-733-2020
Practice Address - Fax:702-794-2797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCN9275OtherMEDICARE RAILROAD CARRIER
NVCN9275OtherMEDICARE RAILROAD CARRIER