Provider Demographics
NPI:1003985912
Name:SOMERS, JAMES C (MS, PA-C, DFAAPA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:SOMERS
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Gender:M
Credentials:MS, PA-C, DFAAPA
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Mailing Address - Street 1:3315 E RUSSELL RD
Mailing Address - Street 2:SUITE A-4 #410
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3459
Mailing Address - Country:US
Mailing Address - Phone:702-522-9455
Mailing Address - Fax:702-522-9227
Practice Address - Street 1:2780 S JONES BLVD
Practice Address - Street 2:SUITE #205
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5628
Practice Address - Country:US
Practice Address - Phone:702-217-8030
Practice Address - Fax:702-537-5736
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2014-10-25
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Provider Licenses
StateLicense IDTaxonomies
NVPA658363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVS68514Medicare UPIN