Provider Demographics
NPI:1821867029
Name:RED ROCK PAIN SPECIALISTS, LLC
Entity Type:Organization
Organization Name:RED ROCK PAIN SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLOSHCHAPOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-205-1041
Mailing Address - Street 1:6415 S FORT APACHE RD STE 185-1005
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-6744
Mailing Address - Country:US
Mailing Address - Phone:702-829-6386
Mailing Address - Fax:702-479-1983
Practice Address - Street 1:3935 S DURANGO DR STE C2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-4170
Practice Address - Country:US
Practice Address - Phone:702-829-6386
Practice Address - Fax:800-540-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty