Stark Industries Medical

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA1068 Issued in NV

Legal business name

STARK INDUSTRIES MEDICAL

Practice address

6647 Brooklyn Heights St
Las Vegas, NV 89166-8020

Phone

(702) 250-9022

Fax

(702) 685-6896

NPI assigned

Feb 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian William Stark Jr., PA-C

Title

President

Phone

(702) 250-9022

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1194047282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6647 BROOKLYN HEIGHTS ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891668020",
            "telephone_number": "702-250-9022",
            "fax_number": "702-685-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6647 BROOKLYN HEIGHTS ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891668020",
            "telephone_number": "702-250-9022",
            "fax_number": "702-685-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK INDUSTRIES MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-250-9022",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1068",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Starbuck, CPCI
• Starcare LLC
• Lauri R Staretz
• Starfield Emergency Physicians, PPLC
• Starfruit Holdings, LLC
• Stark Medicine
• Stark Medicine McKay Khurana Jeider PLLC
• Stark Medicine McKay Khurana Jeider PLLC
• Beatrice Ann Stark, D.D.S.
• Brian William Stark Jr., PA-C

• Surgical Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.