Provider Demographics
NPI:1962563569
Name:STRIBLEN, JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:STRIBLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:500 E WINDMILL LN
Mailing Address - Street 2:STE 125
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1843
Mailing Address - Country:US
Mailing Address - Phone:702-263-4795
Mailing Address - Fax:702-263-4804
Practice Address - Street 1:500 E WINDMILL LN
Practice Address - Street 2:STE 125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1843
Practice Address - Country:US
Practice Address - Phone:702-263-4795
Practice Address - Fax:702-263-4804
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV10246207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36642Medicare PIN
NVH66105Medicare UPIN