Burn and Reconstructive Centers of Nevada, LLC
Organization Active NPI Specialist · Las Vegas, NV
NPI 1073087680 · NPPES record last updated Oct 11, 2022
Key facts
- NPI
- 1073087680
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- BURN AND RECONSTRUCTIVE CENTERS OF NEVADA, LLC
- Practice address
- 3186 S Maryland Pkwy
Las Vegas, NV 89109-2317 - Phone
- (706) 863-9595
- Fax
- (706) 868-8375
- NPI assigned
- Jan 16, 2019
- Organization subpart
- No
Authorized official
- Name
- Shawn Fagan
- Title
- Owner/MD
- Phone
- (706) 863-9595
Practitioners 1
-
Shawn P Fagan, M.D.
National Provider Directory
Locations
4441 Atlanta Rd SE
Smyrna, GA 30080
Phone 7707021806 ext. 210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Mailing address
PO Box 12357
Augusta, GA 30914-2357
Phone (706) 863-9595
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.