Provider Demographics
NPI:1265485825
Name:OPHTHALMIC ASSOCIATES
Entity type:Organization
Organization Name:OPHTHALMIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BOBBETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-870-2020
Mailing Address - Street 1:3016 W CHARLESTON BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1944
Mailing Address - Country:US
Mailing Address - Phone:702-870-2020
Mailing Address - Fax:702-870-3429
Practice Address - Street 1:3016 W CHARLESTON BLVD
Practice Address - Street 2:STE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1944
Practice Address - Country:US
Practice Address - Phone:702-870-2020
Practice Address - Fax:702-870-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVB99147Medicare UPIN
NVV18WCHCL09Medicare ID - Type UnspecifiedGRACE S. SHIN, MD
NVU76934Medicare UPIN
NVV31903Medicare ID - Type UnspecifiedTUSHINA A. REDDY, MD
NVC85556Medicare UPIN
NVV18WCHCL02Medicare ID - Type UnspecifiedKEVIN N. MILLER, MD
NVV40526Medicare ID - Type UnspecifiedADAM A. SCHWARTZ, OD
NVV18WCHCL05Medicare ID - Type UnspecifiedEMILY L. FANT, MD
NVG93914Medicare UPIN
NVVWCHCLMedicare ID - Type UnspecifiedOPHTHALMIC ASSOCIATES
NVG02279Medicare UPIN