Provider Demographics
NPI:1730192337
Name:MCANELLY, ROBERT DENNIS (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DENNIS
Last Name:MCANELLY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6900 PECOS RD
Mailing Address - Street 2:SUITE 2B153 NEUROLOGY CLINIC, VA SO. NEVADA
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-4400
Mailing Address - Country:US
Mailing Address - Phone:702-791-9161
Mailing Address - Fax:702-224-6088
Practice Address - Street 1:6900 PECOS RD
Practice Address - Street 2:SUITE 2B153 NEUROLOGY CLINIC, VA SO. NEVADA
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9161
Practice Address - Fax:702-224-6088
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2015-02-23
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Provider Licenses
StateLicense IDTaxonomies
NV8808208100000X, 2081P0004X, 2081P2900X
TXH4529208100000X, 2081P0004X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN