Provider Demographics
NPI:1124456397
Name:M AND M PAIGE, INC.
Entity type:Organization
Organization Name:M AND M PAIGE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-979-6264
Mailing Address - Street 1:8960 W TROPICANA AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8142
Mailing Address - Country:US
Mailing Address - Phone:702-979-6264
Mailing Address - Fax:702-979-6268
Practice Address - Street 1:8960 W TROPICANA AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8142
Practice Address - Country:US
Practice Address - Phone:702-979-6264
Practice Address - Fax:702-979-6268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVFW172ZMedicare UPIN