Provider Demographics
NPI:1851742100
Name:WOLFORD, DAX PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:DAX
Middle Name:PATRICK
Last Name:WOLFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4525 DEAN MARTIN DR UNIT 2203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-8117
Mailing Address - Country:US
Mailing Address - Phone:929-246-7610
Mailing Address - Fax:
Practice Address - Street 1:4270 S DECATUR BLVD STE B6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-6802
Practice Address - Country:US
Practice Address - Phone:027-410-7825
Practice Address - Fax:702-946-0409
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY3075462084P0800X
NV223632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry