Provider Demographics
NPI:1992963664
Name:DUNSMOOR, KEVIN M (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:DUNSMOOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7010 SMOKE RANCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-8399
Mailing Address - Country:US
Mailing Address - Phone:702-228-7054
Mailing Address - Fax:702-381-9418
Practice Address - Street 1:7010 SMOKE RANCH RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8399
Practice Address - Country:US
Practice Address - Phone:702-228-7054
Practice Address - Fax:702-381-9418
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1410207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV24262OtherLAB
NVVWCGZTOtherMEDICARE GROUP
NVVWCGZTOtherMEDICARE GROUP
NVV104319Medicare PIN