Provider Demographics
NPI:1801664347
Name:BHATNAGAR PROSTATE CANCER INSTITUTE OF NEVADA PC
Entity type:Organization
Organization Name:BHATNAGAR PROSTATE CANCER INSTITUTE OF NEVADA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATNAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-553-4901
Mailing Address - Street 1:PO BOX 15088
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-5088
Mailing Address - Country:US
Mailing Address - Phone:702-553-4901
Mailing Address - Fax:702-553-4902
Practice Address - Street 1:4425 S PECOS RD STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5039
Practice Address - Country:US
Practice Address - Phone:702-553-4901
Practice Address - Fax:702-553-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty