Provider Demographics
NPI:1871503359
Name:CAIMOL, JOSEPH S (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:CAIMOL
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:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:1302 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0246
Practice Address - Country:US
Practice Address - Phone:702-657-9555
Practice Address - Fax:702-657-9040
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9386207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1871503359Medicaid
NVDZ985ZMedicare PIN
NVPENDINGMedicare PIN
NVDZ985YMedicare PIN