Lucas R Vandermyde, DO
Family Medicine in Nellis Afb, NV. Individual provider (NPI-1).
NPI number1164083523
StatusActive
Last updated in NPPESFeb 20, 2025
Details
- NPI
- 1164083523
- Entity type
- Individual (NPI-1)
- Name
- Lucas R Vandermyde
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2019
- Certification date
- Feb 20, 2025
- Last updated
- Feb 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 2472 | NE | Yes |
Practice location
4700 Las Vegas Blvd NNellis Afb, NV 89191-6600
Phone 702-653-2273
Mailing address
4700 Las Vegas Blvd NNellis Afb, NV 89191-6600
Phone 702-653-2273
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All 43 Family Medicine Physician providers in Nellis Afb · All 856 providers in Nellis Afb
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