Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 7367 | NV |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 7367 | NV |
NPI | 1053320564 |
---|---|
Provider Name | Dr. Robert J Tait |
First Address | Henderson, NV 89052-4266 |
Second Address | Henderson, NV 89052-4266 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 13/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002019672 | (05) | NV |
200032264 | RAILROAD MEDICARE (01) | NV |
F84252 | (02) | NV |