EMERGENCY MEDICINE PHYSICIANS OF CLARK UMC MCCOURT PLLC - NPI NUMBER 1427359447

Summary

Provider Name: EMERGENCY MEDICINE PHYSICIANS OF CLARK UMC MCCOURT PLLC

NPI Number: 1427359447

Clasification: Emergency Medicine (207P00000X)

Address:
1800 W CHARLESTON BLVD
LAS VEGAS, NV
ZIP 89102

Phone Number: (702) 383-2085



Detailed Information

EMERGENCY MEDICINE PHYSICIANS OF CLARK UMC MCCOURT PLLC is an emergency physician in Las Vegas, NV. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. The assigned NPI number for this provider is 1427359447 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

1800 W CHARLESTON BLVD
LAS VEGAS, NV
ZIP 89102-329
Phone: (702) 383-2085

The provider's authorized official is David C Packo .
The authorized official title is President and has the following contact phone number (330) 493-4443.

The enumeration date for this NPI number is 11/8/2010 and was last updated on 1/14/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207P00000X Emergency Medicine Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 1427359447 MEDICAID NV
2 EI639A MEDICARE PIN NV

NPI Record

No. Field Name Field Value
1 NPI 1427359447
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name EMERGENCY MEDICINE PHYSICIANS OF CLARK UMC MCCOURT PLLC
5 Provider First Line Business Practice Location Address 1800 W CHARLESTON BLVD
6 Provider Business Practice Location Address City Name LAS VEGAS
7 Provider Business Practice Location Address State Name NV
8 Provider Business Practice Location Address Postal Code 891022329
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 7023832085
11 Provider Enumeration Date 11/8/2010
12 Last Update Date 1/14/2013
13 Authorized Official Last Name PACKO
14 Authorized Official First Name DAVID
15 Authorized Official Middle Name C
16 Authorized Official Title or Position PRESIDENT
17 Authorized Official Telephone Number 3304934443
18 Healthcare Provider Taxonomy Code 1 207P00000X
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Other Provider Identifier 1 1427359447
21 Other Provider Identifier Type Code 1 05
22 Other Provider Identifier State 1 NV
23 Other Provider Identifier 2 EI639A
24 Other Provider Identifier Type Code 2 08
25 Other Provider Identifier State 2 NV
26 Is Organization Subpart N
27 Authorized Official Credential Text MD
28 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.