Provider Demographics
NPI:1538707393
Name:JAMESON, PATRICK SCOTT (PA-C)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:SCOTT
Last Name:JAMESON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2110 E FLAMINGO RD STE 213
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5193
Mailing Address - Country:US
Mailing Address - Phone:702-255-6647
Mailing Address - Fax:
Practice Address - Street 1:6460 MEDICAL CENTER ST STE 350
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2423
Practice Address - Country:US
Practice Address - Phone:702-255-6647
Practice Address - Fax:702-933-1444
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2021-09-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant