Provider Demographics
NPI:1801095690
Name:LAS VEGAS GENERAL SURGERY LLC
Entity type:Organization
Organization Name:LAS VEGAS GENERAL SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOFFLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-894-4440
Mailing Address - Street 1:PO BOX 370331
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0331
Mailing Address - Country:US
Mailing Address - Phone:702-894-4440
Mailing Address - Fax:702-894-9917
Practice Address - Street 1:3201 S MARYLAND PARKWAY
Practice Address - Street 2:SUITE 601
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109
Practice Address - Country:US
Practice Address - Phone:702-894-4440
Practice Address - Fax:702-894-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9075208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018307Medicaid
G94867Medicare UPIN
36434Medicare PIN