Provider Demographics
NPI:1801902234
Name:THE NEVADA MEDICAL GROUP
Entity type:Organization
Organization Name:THE NEVADA MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARNERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-914-7150
Mailing Address - Street 1:2200 W. HORIZON RIDGE PARKWAY
Mailing Address - Street 2:SUITE F
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2637
Mailing Address - Country:US
Mailing Address - Phone:702-314-7150
Mailing Address - Fax:
Practice Address - Street 1:2200 W. HORIZON RIDGE PARKWAY
Practice Address - Street 2:SUITE F
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89052-2637
Practice Address - Country:US
Practice Address - Phone:702-314-7150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV40542Medicare ID - Type Unspecified