Provider Demographics
NPI:1134165723
Name:MCBEATH, ROBERT B (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:MCBEATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-560-2916
Mailing Address - Fax:702-560-2928
Practice Address - Street 1:3150 N TENAYA WAY STE 165
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0462
Practice Address - Country:US
Practice Address - Phone:702-877-0814
Practice Address - Fax:702-877-3238
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6974174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019358Medicaid
340014934OtherRAILROAD MEDICARE PIN
NV1134165723Medicaid
340014934OtherRAILROAD MEDICARE PIN
NV002019358Medicaid