Provider Demographics
NPI:1134375918
Name:NEIBAUR, DARRICK WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:DARRICK
Middle Name:WILLIAM
Last Name:NEIBAUR
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1505 WIGWAM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8195
Mailing Address - Country:US
Mailing Address - Phone:702-896-9591
Mailing Address - Fax:702-896-9591
Practice Address - Street 1:1505 WIGWAM PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8195
Practice Address - Country:US
Practice Address - Phone:702-896-6043
Practice Address - Fax:702-896-9591
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2024-01-03
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Provider Licenses
StateLicense IDTaxonomies
NV1702207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1134375918Medicaid