Provider Demographics
NPI:1265638266
Name:LAPAROSCOPIC SURGERY OF NEVADA LLC
Entity type:Organization
Organization Name:LAPAROSCOPIC SURGERY OF NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RIVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-263-9644
Mailing Address - Street 1:8285 W ARBY AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2238
Mailing Address - Country:US
Mailing Address - Phone:702-263-9644
Mailing Address - Fax:702-270-4062
Practice Address - Street 1:8285 W ARBY AVE STE 190
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2238
Practice Address - Country:US
Practice Address - Phone:702-263-9644
Practice Address - Fax:702-270-4062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104733Medicare PIN