GEORGE R MCMICKLE M D P C NPI 1972931426

NPI Information

NPI: 1972931426
Provider Name: GEORGE R MCMICKLE M D P C

Doing Business As: SOUTHWESTERN EYE ASSOCIATES

Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

CLIA Number: 29D2086063

Address:
653 N TOWN CENTER DR
SUITE 318
LAS VEGAS, NV
ZIP 89144
Phone: (702) 215-6950
Get Directions

GEORGE R MCMICKLE M D P C is an ophthalmologic surgery clinic center in Las Vegas, NV. GEORGE R MCMICKLE M D P C NPI is 1972931426. The provider is registered as an organization entity type.
The provider Is Doing Business As Southwestern Eye Associates.

The provider's business location address is:

653 N TOWN CENTER DR
SUITE 318
LAS VEGAS, NV
ZIP 89144-514
Phone: (702) 215-6950
Fax: (702) 215-3377

The provider's authorized official is George R Mcmickle .
The authorized official title is President and has the following contact phone number (702) 215-6950.

The CLIA number assigned to this NPI record is 29D2086063 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/18/2013 and was last updated on 10/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	261QS0132X	Clinic/Center	Ophthalmologic Surgery	NV9367	NEVADA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G40365	MEDICARE UPIN	NEVADA
2	2018497	MEDICAID	NEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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