Provider Demographics
NPI:1063078830
Name:JANIK, PATRICK EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:EDWARD
Last Name:JANIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 S FORT APACHE RD STE 1851004
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-6744
Mailing Address - Country:US
Mailing Address - Phone:702-530-7069
Mailing Address - Fax:
Practice Address - Street 1:6415 S FORT APACHE RD STE 1851004
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-6744
Practice Address - Country:US
Practice Address - Phone:702-530-7069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO35882084P0800X
NV390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program