1578123105 NPI number — MCWHORTER EF ANESTHESIA, PROFESSIONAL CORPORATION

Table of content: PAUL QUENTIN SMITH M.D. (NPI 1801958913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578123105 NPI number — MCWHORTER EF ANESTHESIA, PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCWHORTER EF ANESTHESIA, PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578123105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 93358
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89193-3358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-487-6510
Provider Business Mailing Address Fax Number:
702-405-7960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 GREEN VALLEY PKWY
Provider Second Line Business Practice Location Address:
112
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-487-6510
Provider Business Practice Location Address Fax Number:
702-405-7960
Provider Enumeration Date:
06/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
MCWHORTER
Authorized Official First Name:
YI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
562-843-1024

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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