Provider Demographics
NPI:1255536322
Name:ANANT SONPATKI MD PC
Entity type:Organization
Organization Name:ANANT SONPATKI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANANT
Authorized Official - Middle Name:K
Authorized Official - Last Name:SONPATKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-492-1700
Mailing Address - Street 1:PO BOX 777418
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89077-7418
Mailing Address - Country:US
Mailing Address - Phone:702-492-1700
Mailing Address - Fax:702-492-6816
Practice Address - Street 1:6325 S JONES BLVD STE 500
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3336
Practice Address - Country:US
Practice Address - Phone:702-631-4700
Practice Address - Fax:702-818-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104442Medicare PIN