Provider Demographics
NPI:1063606291
Name:ALAN J. SACKS, M.D., LTD, PC
Entity type:Organization
Organization Name:ALAN J. SACKS, M.D., LTD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-471-7721
Mailing Address - Street 1:2020 GOLDRING AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4000
Mailing Address - Country:US
Mailing Address - Phone:702-471-7721
Mailing Address - Fax:702-471-7780
Practice Address - Street 1:2020 GOLDRING AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4000
Practice Address - Country:US
Practice Address - Phone:702-471-7721
Practice Address - Fax:702-471-7780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAN J. SACKS, M.D., PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-30
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9280207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018264Medicaid
1265407183OtherNPI FOR ALAN J. SACKS,M.D
1265407183OtherNPI FOR ALAN J. SACKS,M.D
NV2018264Medicaid