George R McMickle M D P C

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

NV9367 Issued in NV

Legal business name

GEORGE R MCMICKLE M D P C

Practice address

653 N Town Center Dr
Suite 318
Las Vegas, NV 89144-0514

Phone

(702) 215-6950

Fax

(702) 215-3377

NPI assigned

Oct 18, 2013

Organization subpart

No

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

Authorized official

Name

George R McMickle, M DNPI 1912935065

Title

President

Phone

(702) 215-6950

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SOUTHWESTERN EYE ASSOCIATES Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Las Vegas Surgicare LTD

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1467415513

  Member Of

  NPD member
• Sahara Outpatient Surgery Center LTD

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1023071180

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George McMickle, MD

  • Ophthalmology Physician
  • Las Vegas, NV
  • NPI 1912935065

  NV

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1972931426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "SUITE 318",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-215-6950",
            "fax_number": "702-215-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "SUITE 318",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-215-6950",
            "fax_number": "702-215-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE R MCMICKLE M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "MCMICKLE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-215-6950",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "NV",
            "license": "NV9367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018497",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHWESTERN EYE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George a Tanksley Jr DMD a Professinal Corporation
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• George G Westerman, MD, Cpe, Facpe
• George Med - Peds Associates PC
• Akeem Anthony George, M.D.
• Carolyn George
• Chenese Cindy George
• Christine M George, M.D.
• Constantine George, MD

• All providers in Las Vegas, NV
• Ophthalmologic Surgery Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.