Provider Demographics
NPI:1972240141
Name:HEALING HANDS SURGERY CENTER LLC
Entity Type:Organization
Organization Name:HEALING HANDS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YEVGENIY
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAVKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-701-2490
Mailing Address - Street 1:6462 LOSEE RD # 110-900
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-0103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4275 BURNHAM AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5400
Practice Address - Country:US
Practice Address - Phone:702-701-2490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical