Provider Demographics
NPI:1972771723
Name:ORTHOPAEDIC SPECIALISTS OF NEVADA
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPECIALISTS OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-388-1008
Mailing Address - Street 1:701 S TONOPAH DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4030
Mailing Address - Country:US
Mailing Address - Phone:702-388-1008
Mailing Address - Fax:702-388-1841
Practice Address - Street 1:2020 PALOMINO LN
Practice Address - Street 2:SUITE 220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4812
Practice Address - Country:US
Practice Address - Phone:702-474-7200
Practice Address - Fax:702-474-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00434921Medicare PIN
NVVWQBCQMedicare PIN
NVP00421426Medicare PIN
NV1060210001Medicare NSC