Provider Demographics
NPI:1922075498
Name:SEIP, DOUGLAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:SEIP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4132 S RAINBOW BLVD
Mailing Address - Street 2:#315
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:702-304-1911
Mailing Address - Fax:702-304-2611
Practice Address - Street 1:5765 S FORT APACHE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5625
Practice Address - Country:US
Practice Address - Phone:702-304-1911
Practice Address - Fax:702-304-2611
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2008-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV4420207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002004212Medicaid
34008Medicare ID - Type Unspecified
NV002004212Medicaid