Provider Demographics
NPI:1801812946
Name:MICHAEL KARAGIOZIS DO LTD
Entity type:Organization
Organization Name:MICHAEL KARAGIOZIS DO LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FITTING
Authorized Official - Last Name:KARAGIOZIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-567-9980
Mailing Address - Street 1:10624 S EASTERN AVE
Mailing Address - Street 2:SUITE A-745
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2982
Mailing Address - Country:US
Mailing Address - Phone:702-567-9980
Mailing Address - Fax:702-567-9985
Practice Address - Street 1:3017 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1941
Practice Address - Country:US
Practice Address - Phone:702-567-9980
Practice Address - Fax:702-567-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG90811Medicare UPIN