Provider Demographics
NPI:1831383611
Name:LIBBY ORTHOPEDIC TRAUMA LLP
Entity type:Organization
Organization Name:LIBBY ORTHOPEDIC TRAUMA LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LIBBY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-898-9060
Mailing Address - Street 1:2749 SUNRIDGE HEIGHTS PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5044
Mailing Address - Country:US
Mailing Address - Phone:702-898-9060
Mailing Address - Fax:702-898-9031
Practice Address - Street 1:2749 SUNRIDGE HEIGHTS PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5044
Practice Address - Country:US
Practice Address - Phone:702-898-9060
Practice Address - Fax:702-898-9031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV587207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty